Congenital heart disease: Difference between revisions
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== | == Background == | ||
==Treatment (by presentation)== | *Cyanotic | ||
# Cyanosis (shunt) | **Tetralogy | ||
**Tricuspid anomalies | |||
**Truncus arteriosus | |||
**Total anomalous pulmonary venous return | |||
**Transposition | |||
*Acyanotic | |||
**VSD | |||
**ASD | |||
**PDA | |||
**AV canal | |||
**Pulmonary/aortic stenosis | |||
== Diagnosis == | |||
{| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%" | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Clinical Presentation | |||
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Causative Conditions in Neonates | |||
! valign="top" bgcolor="#ffffff" align="left" rowspan="0" | Causative Conditions in Infants and Children | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Cyanosis | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Transposition of the great arteries, TOF, tricuspid atresia, truncus arteriosus, total anomalous pulmonary venous return | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | TOF, Eisenmenger complex | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Cardiovascular shock | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Critical AS, coarctation of the aorta, HLHS | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Coarctation of the aorta (infants) | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Congestive heart failure | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Rare: PDA, HLHS | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | PDA, VSD, ASD, atrioventricular canal | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Murmur | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | PDA, valvular defects (AS, PS) | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | VSD, ASD, PDA, outflow obstructions, valvular defects (AS, PS) | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Syncope | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | — | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | AS, PS, Eisenmenger complex | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Hypertension | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | — | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Coarctation of the aorta | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Arrhythmias | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | — | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ASD, Ebstein anomaly, postsurgical complication after repair of congenital heart defect | |||
|} | |||
== Treatment (by presentation) == | |||
#Cyanosis (shunt) | |||
##PGE1* (0.01mg/kg; may repeat at double dose x 3) | ##PGE1* (0.01mg/kg; may repeat at double dose x 3) | ||
##pressors | ##pressors | ||
# Tet spells | #Tet spells | ||
##knee chest position | ##knee chest position | ||
##O2 | ##O2 | ||
# CHF | #CHF | ||
##diuretis, NTG, inotrops | ##diuretis, NTG, inotrops | ||
# Shock (resrictive lesion) | #Shock (resrictive lesion) | ||
##Dobutamine | ##Dobutamine | ||
==PGE1 Side Effects== | == PGE1 Side Effects == | ||
#Apnea (intubate) | #Apnea (intubate) | ||
#Hypotension | #Hypotension | ||
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#Flushing | #Flushing | ||
[[Category:Peds]] | <br/>[[Category:Peds]] <br/>[[Category:Cards]] <br/><br/><br/> | ||
[[Category:Cards]] | |||
Revision as of 17:40, 22 June 2011
Background
- Cyanotic
- Tetralogy
- Tricuspid anomalies
- Truncus arteriosus
- Total anomalous pulmonary venous return
- Transposition
- Acyanotic
- VSD
- ASD
- PDA
- AV canal
- Pulmonary/aortic stenosis
Diagnosis
| Clinical Presentation | Causative Conditions in Neonates | Causative Conditions in Infants and Children |
|---|---|---|
| Cyanosis | Transposition of the great arteries, TOF, tricuspid atresia, truncus arteriosus, total anomalous pulmonary venous return | TOF, Eisenmenger complex |
| Cardiovascular shock | Critical AS, coarctation of the aorta, HLHS | Coarctation of the aorta (infants) |
| Congestive heart failure | Rare: PDA, HLHS | PDA, VSD, ASD, atrioventricular canal |
| Murmur | PDA, valvular defects (AS, PS) | VSD, ASD, PDA, outflow obstructions, valvular defects (AS, PS) |
| Syncope | — | AS, PS, Eisenmenger complex |
| Hypertension | — | Coarctation of the aorta |
| Arrhythmias | — | ASD, Ebstein anomaly, postsurgical complication after repair of congenital heart defect |
Treatment (by presentation)
- Cyanosis (shunt)
- PGE1* (0.01mg/kg; may repeat at double dose x 3)
- pressors
- Tet spells
- knee chest position
- O2
- CHF
- diuretis, NTG, inotrops
- Shock (resrictive lesion)
- Dobutamine
PGE1 Side Effects
- Apnea (intubate)
- Hypotension
- Bradycardia
- Hyperexia
- Flushing