SOBRERA, Alexia Krystin F.

BSN-IIIC4
CONGENITAL HEART DISEASES A. Acyanotic Type of Heart Disease 1. Atrial Septal Defect Increased pulmonary blood flow

Picture

Type of Shunting -Allows oxygenated blood returning from the lungs to pass into the right atrium (left to right shunt) - An ASD is a hole in the part of the septum that separates the atria - the upper chambers of the heart. This heart defect allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing to the left ventricle as it should

2.

Ventricular Septal Defect Increased pulmonary blood flow

-Allows systemic venous and oxygenated arterial blood to mix (right to left shunt) - A VSD is a hole in the part of the septum that separates the ventricles the lower chambers of the heart. The hole allows oxygen rich blood to flow from the left ventricle into the right ventricle instead of flowing into the aorta and out to the body as it should

Signs and Symptoms Frequent respiratory or lung infections Difficulty breathing Tiring when feeding (infants) Shortness of breath when being active or exercising Skipped heartbeats or a sense of feeling the heartbeat A heart murmur, or a whooshing sound that can be heard with a stethoscop Swelling of legs, feet, or stomach are Stroke Shortness of breath, Fast or heavy breathing, Sweating, Tiredness while feeding, or Poor weight gain.

Surgical Management -Open-heart surgery may also be done to repair ASD. Using open-heart surgery, the septum can be closed using stitches. Another way to cover the hole is with a patch -Cardiac catheterization

-Open-heart surgery -Cardiac catheterization

SOBRERA, Alexia Krystin F. BSN-IIIC4

3. Patent DuctusArteriosus Increased pulmonary blood flow - PDA leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels that carry blood from the heart Fast breathing Poor feeding habits Rapid pulse Shortness of breath Sweating while feeding Tiring very easily Poor growth -A transcatheter device closure is a procedure that uses a thin, hollow tube placed into a blood vessel. The doctor passes a small metal coil or other blocking device through the catheter to the site of the PDA. This blocks blood flow through the vessel. These coils can help the baby avoid surgery. -Surgery may be needed if the catheter procedure does not work or it cannot be used. Surgery involves making a small cut between the ribs to repair the PDA. -This can be done with surgery or a procedure called balloon angioplasty. A balloon angioplasty is a procedure that uses a thin, flexible tube, called a catheter, which is inserted into a blood vessel and directed to the aorta. When the catheter reaches the narrow area of the aorta, a balloon at the tip is inflated to expand the blood vessel. Sometimes a mesh-covered tube(stent) is inserted to keep the vessel open. The stent is used more often to initially widen the aorta or rewiden it if the aorta narrows again after surgery has been performed.

4.

Coarctation of the Aorta -Obstruction to flow

-Narrowing of the lumen of the aorta -The defect can affect the body's blood circulation because the left side of the heart has to work harder to pump blood through the narrowed aorta. Sometimes the narrowing is minor and might not even cause symptoms. In other cases the aorta may be more constricted, placing a strain on the heart's left ventricle (the chamber that pumps blood to the aorta and out to the body). -A coarctation can occur anywhere in the aorta, but

pale skin irritability heavy sweating difficulty breathing

SOBRERA, Alexia Krystin F. BSN-IIIC4

most often is found just beyond the point where the arteries that carry the blood to the upper body and head branch off from the aorta. 5. Aortic Valve Stenosis Obstruction to flow - Occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from the heart into the aorta and onward to the rest of the body. Chest pain (angina) or tightness Feeling faint or fainting with exertion Shortness of breath, especially with exertion Fatigue, especially during times of increased activity Heart palpitations sensations of a rapid, fluttering heartbeat Heart murmur Heart murmur an abnormal whooshing sound heard using a stethoscope, caused by turbulent blood flow Shortness of breath, especially during exertion Chest pain Loss of consciousness (fainting) Fatigue Palpitations During surgery to correct a coarctation, the narrow portion is removed and the aorta is reconstructed or patched to allow blood to flow normally through the aorta. -Balloon valvuloplasty (valvotomy) -Aortic valve replacement -Transcatheter aortic valve replacement (TAVR) -Surgical valvuloplasty

6.

Pulmonic Valve Stenosis Obstruction to flow

-A condition in which the flow of blood from the heart to the lungs is slowed by a deformity on or near your pulmonary valve, the tissue that controls the blood flow from your heart to the lungs

-Balloon valvuloplasty (valvotomy) -Open-heart surgery

SOBRERA, Alexia Krystin F. BSN-IIIC4

B. Cyanotic Type of Heart Disease 1. Tetralogy of Fallot Decreased pulmonary blood flow

Picture

Type of Shunting -Ventricular septal defect -Pulmonary stenosis -Right ventricular hypertrophy -Overriding aorta

Signs and Symptoms A higher risk of getting an infection of the layers of the heart, called endocarditis. A higher risk of having irregular heart rhythms, called arrhythmia. Dizziness, fainting, or seizures, because of the low oxygen levels in their blood. Delayed growth and development

Management -Surgery to repair tetralogy of Fallot is done when the infant is very young. Sometimes more than one surgery is needed. When more than one surgery is used, the first surgery is done to help increase blood flow to the lungs. -Surgery to correct the problem may be done at a later time. Often only one corrective surgery is performed in the first few months of life. Corrective surgery is done to widen part of the narrowed pulmonary tract and close the ventricular septal defect.

2.

Tricuspid Atresia Decreased pulmonary blood flow

-Tricuspid atresia is a heart defect present at birth (congenital) in which one of the valves (tricuspid valve) between two of the heart's chambers isn't formed. Instead, there's solid tissue between the chambers. -If your baby is born with tricuspid atresia, blood can't flow through the heart and

Blue tinge to the skin and lips (cyanosis) Difficulty breathing (dyspnea) Tiring easily, especially during feedings Slow growth Fatigue and weakness Shortness of breath Swelling (edema) in the legs, ankles and

-Atrial septostomy -Shunting -Glenn Procedure -Fontan Procedure

SOBRERA, Alexia Krystin F. BSN-IIIC4

into the lungs to pick up oxygen as it normally would. feet Swelling of the abdomen (ascites) Sudden weight gain from fluid retention Irregular or rapid heartbeat

3.

Transposition of the Great Vessels Mixed blood flow

-Transposition of the great vessels is a cyanotic heart defect. This means there is decreased oxygen in the blood that is pumped from the heart to the rest of the body. -In transposition of the great vessels, the blood goes to the lungs, picks up oxygen, returns to the heart, and then flows right back to the lungs without ever going to the body. Blood from the body returns to the heart and goes back to the body without ever picking up oxygen in the lungs.

Blueness of the skin Clubbing of the fingers or toes Poor feeding Shortness of breath

-Balloon atrial septostomy -An arterial switch procedure is used to permanently correct the problem within the baby's first week of life. This surgery switches the great arteries back to the normal position and keeps the coronary arteries attached to the aorta

SOBRERA, Alexia Krystin F. BSN-IIIC4

4. Truncus Arteriosus Mixed blood flow -It means that one large blood vessel leads out of the heart. Normally, there are two separate vessels coming out of the heart. -In addition, the two lower chambers of the heart are missing a portion of the wall that divides them. As a result of truncus arteriosus, oxygen-poor blood that should go to the lungs and oxygenrich blood that should go to the rest of the body are mixed together. This creates severe circulatory problems. Blue coloring of the skin (cyanosis) Poor feeding Excessive sleepiness Poor growth Shortness of breath (dyspnea) Rapid breathing (tachypnea) Irregular heartbeats (arrhythmia) Excessive sweating (diaphoresis) Poor weight gain Excessive sleepiness -Corrective surgery: Close the hole between the two ventricles, often with a patch Separate the upper portion of the pulmonary artery from the single large vessel Implant a tube (conduit) and valve to connect the right ventricle with the upper portion of the pulmonary artery creating a new, complete pulmonary artery Reconstruct the single large vessel and aorta to create a new, complete aorta Implant a new valve separating the left ventricle and aorta if needed

-Cardiac catheterization with an inflatable balloon tip

Reference: http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=truncus+arteriosus&x=0&y=0 http://www.mayoclinic.com/print/truncus-arteriosus/DS00746/DSECTION=all&METHOD=print nd 2 year notes on Pediatrics