Cardiovascular System and Disorders in Children

Overview of the Cardiovascular System and Disorders in Children

• Key terms related to the cardiovascular system include arrhythmia, cardiomegaly, echocardiography, electrocardiogram, heart failure, orthotopic, and polycythemia.
• The development of the cardiovascular system in fetuses includes the presence of fetal heart rate around postconceptual day 17, the formation of heart chambers and arteries during gestational weeks 2 through 8, and the oxygenation of the fetus via the placenta.
• Changes from fetal to neonatal circulation include the closure of the foramen ovale and ductus arteriosus.
• Cardiovascular changes in childhood include the heart rate and blood pressure increasing as the child ages, and reaching adult levels by adolescence.
• Signs of a cardiac disorder in children may include cyanosis, irregular heart rate, edema, fever, retraction or increased work of breathing, prominence of precordial chest wall, visible, engorged, or abnormal pulsations, and abdominal distention.
• Risk factors for cardiovascular disorders in childhood include congenital malformations, genetic syndromes, family history, maternal drug or alcohol exposure, prematurity, infections, obesity, diabetes, hypertension, chemotherapy, other diseases, organ transplant, and hyperlipidemia.
• Diagnostic tests for cardiovascular disorders include pulse oximetry, electrocardiogram, echocardiogram, chest radiograph, exercise stress testing, laboratory tests, arteriogram, and cardiac catheterization.
• Past health history that may indicate a cardiac disorder includes congenital malformation, frequent infections, chromosomal abnormalities, prematurity, autoimmune disorders, and use of medications like corticosteroids.
• Characteristics of heart murmurs include intensity graded from I to VI.
• Clubbing of the fingers and toes may indicate chronic hypoxia due to congenital heart disease.
• CHD is classified based on hemodynamic characteristics, including obstructive disorders, disorders with decreased pulmonary blood flow, disorders with increased pulmonary blood flow, and mixed disorders.
• Cardiovascular disorders in children include infective endocarditis, acute rheumatic fever, cardiomyopathy, Kawasaki disease, and may require psychosocial interventions, parent teaching, and therapeutic management.