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  • 1. Clinical Sciences III
  • 2. Aortic Stenosis
    • obstruction to flow between left ventricle and aorta
    • Causes:
      • Muscular obstruction below aortic valve
      • Obstruction at valve itself **(BAV)
      • Aortic narrowing above the valve
    • Signs and Symptoms
      • Mild to moderate:
        • Detectable heart murmur
        • Often no symptoms
      • Severe:
        • Newborn = heart failure
        • Older child =
          • Chest pain
          • Lightheadedness
          • Fainting spells with exercise
  • 3. Aortic Stenosis
  • 4. Treatment for Aortic Stenosis
    • Palliative & depends on type of valve abnormality
      • Balloon dilation valvuloplasty
      • Valvotomy
      • Ross procedure
      • Konno procedure
  • 5. Atrial Septal Defect
    • Hole in septum that divides the chambers of the heart
    • Untreated…may cause problems in adulthood
      • Pulmonary hypertension
      • CHF
      • Artial arrhythmias
      • Inc risk of stroke
  • 6. Atrial Septal Defect
    • Often no symptoms
    • Large defect
      • SOB
      • Easy fatigability
      • Poor growth
    • Heart murmur
    • Treatment
      • Closes on its own (to age 3)
      • Open heart surgery
        • Close with sutures/patch
        • Amplatzer Septal Occluder
  • 7. Hypoplastic Left Heart Syndrome
    • Complex cardiac defect seen in newborn
    • All structures on left side of heart underdeveloped
    • S & S
      • O2 saturations, cyanosis, respir distress
      • Weak pulses
      • Lethargy, poor feeding – ultimately severe shock
  • 8. Treatment
    • Cardiac transplantation
    • Staged Reconstruction
      • Norwood Procedure
      • Glenn Procedure
      • Fontan
  • 9. Patent Ductus Arteriosus
    • Ductus arteriosus
      • BV present in babies while in womb
      • Should close within hours after birth
        • Does not in patent ductus arteriosus
        • More common in preemies, but can happen in term infants
      • Treatment
        • Meds to promote closure
        • Surgical ligation
  • 10. Tetralogy of Fallot
    • Pulmonary stenosis
    • Ventricular septal defect
    • Overriding aorta
    • Right ventricular hypertrophy
    • Signs & symptoms
      • Loud murmur / cyanosis
    • Treatment
      • Surgical correction
  • 11. Transposition of Great Arteries
    • Aorta and Pulmonary Artery arise from wrong structures
    • May have other defects
      • VSD
      • Abnormal branching pattern of coronary arteries
      • Narrowing below pulmonary valve
    • Treatment
      • surgical
  • 12. VATER or VACTERL Association
    • V = vertebra
    • A = anal atresia
    • C = cardiac abnormalities
    • TE = tracheoesophogeal fistula
    • R = renal abnormalities
    • L = limb anomalies
    • Usually have 3 or more of these abnormalities
    • Many babies born small and have difficulty gaining wt.
    • Tend to have normal intelligence