This document discusses cardiac disorders in pediatrics, including congenital and acquired disorders. The two major groups are congenital disorders present at birth, and acquired disorders that develop later in life such as bacterial endocarditis. Common congenital defects include atrial and ventricular septal defects, tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome. Management involves medications, oxygen management, nutrition, and surgery depending on the specific defects. Post-operative care focuses on pain management, cardiac monitoring, and family support.
Management of congenital heart disease in infantsSMSRAZA
- Congenital heart disease is the most common birth defect, affecting around 8 per 1000 births. Common defects include ventricular septal defects, atrial septal defects, and tetralogy of Fallot.
- Diagnosis involves a detailed family history, physical exam for murmurs or cyanosis, chest x-ray, electrocardiogram, and echocardiogram. Treatment depends on the specific defect but may include medications, closure devices, surgery, or lifestyle changes.
- Managing congenital heart disease requires a multidisciplinary approach including cardiologists, cardiac surgeons, nutritionists, and mental health professionals to address both physical and psychological needs.
The document provides information on congenital heart defects, including their causes, types, signs and symptoms, diagnosis, and treatment. It discusses several specific defects in detail, including aortic stenosis, coarctation of the aorta, pulmonary stenosis, and patent ductus arteriosus. The key points are:
1. Congenital heart defects can involve the heart's chambers, valves, or vessels and have various causes including genetic syndromes.
2. Specific defects like aortic stenosis and pulmonary stenosis can cause obstruction to blood flow while others like patent ductus arteriosus allow extra blood flow to the lungs.
3. Symptoms depend on the severity of the defect but may include heart failure,
The document discusses various congenital heart defects including their definition, etiology, classification as acyanotic or cyanotic, signs and symptoms, diagnosis, and treatment. Specific defects covered include atrial septal defects, ventricular septal defects, patent ductus arteriosus, and atrioventricular septal defects. The treatment sections provide guidelines for managing each defect medically or surgically depending on its size and severity.
Congenital heart defects (CHDs) are structural abnormalities in the heart present at birth. Most CHDs disrupt normal blood flow through the heart by obstructing blood flow, allowing blood to flow in the wrong direction, or blocking blood flow completely. CHDs are among the most common birth defects and a leading cause of birth defect-related deaths. While most CHDs have no known cause, certain maternal illnesses, medications, genetic syndromes, and family history can increase the risk of a baby being born with a CHD. Diagnostic tests like echocardiograms, electrocardiograms, and cardiac catheterizations are used to evaluate CHDs.
Care of the child with a physical disorder08bholmes
Congenital heart disease affects 5-10% of newborns. Common types include patent ductus arteriosus, atrial septal defects, and ventricular septal defects. Signs include cyanosis, murmurs, and heart failure. Diagnostic tests include EKGs, echocardiograms, and cardiac catheterization. Treatment ranges from medications to close defects to open heart surgery to repair defects. Common blood disorders in children include iron deficiency anemia, sickle cell anemia, and hemophilia.
The document discusses cardiovascular disorders in children, including congenital heart diseases like ventricular septal defect (VSD). It provides details on the anatomy and physiology of the cardiovascular system in children, changes after birth, and diagnostic techniques for congenital heart diseases such as echocardiography and catheterization. VSD is described as a hole in the septum between the right and left ventricles allowing left-to-right shunting, which can cause congestive heart failure or pulmonary hypertension.
Congenital heart disease (CHD) occurs in 1 in 125 live births and is the most common birth defect. The majority of cases have no known cause and are thought to be due to a combination of genetic and environmental factors. Common types of CHD include atrial septal defects, ventricular septal defects, patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Treatment options include medical management, interventional procedures such as catheterization, and surgical repair. Without treatment, CHD can lead to heart failure, lung problems, and other issues.
Management of congenital heart disease in infantsSMSRAZA
- Congenital heart disease is the most common birth defect, affecting around 8 per 1000 births. Common defects include ventricular septal defects, atrial septal defects, and tetralogy of Fallot.
- Diagnosis involves a detailed family history, physical exam for murmurs or cyanosis, chest x-ray, electrocardiogram, and echocardiogram. Treatment depends on the specific defect but may include medications, closure devices, surgery, or lifestyle changes.
- Managing congenital heart disease requires a multidisciplinary approach including cardiologists, cardiac surgeons, nutritionists, and mental health professionals to address both physical and psychological needs.
The document provides information on congenital heart defects, including their causes, types, signs and symptoms, diagnosis, and treatment. It discusses several specific defects in detail, including aortic stenosis, coarctation of the aorta, pulmonary stenosis, and patent ductus arteriosus. The key points are:
1. Congenital heart defects can involve the heart's chambers, valves, or vessels and have various causes including genetic syndromes.
2. Specific defects like aortic stenosis and pulmonary stenosis can cause obstruction to blood flow while others like patent ductus arteriosus allow extra blood flow to the lungs.
3. Symptoms depend on the severity of the defect but may include heart failure,
The document discusses various congenital heart defects including their definition, etiology, classification as acyanotic or cyanotic, signs and symptoms, diagnosis, and treatment. Specific defects covered include atrial septal defects, ventricular septal defects, patent ductus arteriosus, and atrioventricular septal defects. The treatment sections provide guidelines for managing each defect medically or surgically depending on its size and severity.
Congenital heart defects (CHDs) are structural abnormalities in the heart present at birth. Most CHDs disrupt normal blood flow through the heart by obstructing blood flow, allowing blood to flow in the wrong direction, or blocking blood flow completely. CHDs are among the most common birth defects and a leading cause of birth defect-related deaths. While most CHDs have no known cause, certain maternal illnesses, medications, genetic syndromes, and family history can increase the risk of a baby being born with a CHD. Diagnostic tests like echocardiograms, electrocardiograms, and cardiac catheterizations are used to evaluate CHDs.
Care of the child with a physical disorder08bholmes
Congenital heart disease affects 5-10% of newborns. Common types include patent ductus arteriosus, atrial septal defects, and ventricular septal defects. Signs include cyanosis, murmurs, and heart failure. Diagnostic tests include EKGs, echocardiograms, and cardiac catheterization. Treatment ranges from medications to close defects to open heart surgery to repair defects. Common blood disorders in children include iron deficiency anemia, sickle cell anemia, and hemophilia.
The document discusses cardiovascular disorders in children, including congenital heart diseases like ventricular septal defect (VSD). It provides details on the anatomy and physiology of the cardiovascular system in children, changes after birth, and diagnostic techniques for congenital heart diseases such as echocardiography and catheterization. VSD is described as a hole in the septum between the right and left ventricles allowing left-to-right shunting, which can cause congestive heart failure or pulmonary hypertension.
Congenital heart disease (CHD) occurs in 1 in 125 live births and is the most common birth defect. The majority of cases have no known cause and are thought to be due to a combination of genetic and environmental factors. Common types of CHD include atrial septal defects, ventricular septal defects, patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Treatment options include medical management, interventional procedures such as catheterization, and surgical repair. Without treatment, CHD can lead to heart failure, lung problems, and other issues.
This document provides information about congenital heart defects. It discusses common types of defects such as atrial septal defects, ventricular septal defects, patent ductus arteriosus, coarctation of the aorta, pulmonary stenosis, and aortic stenosis. For each defect, it describes the anatomy, causes, signs and symptoms, diagnostic evaluation, and treatment options. The document is an educational presentation that comprehensively covers several major congenital heart defects.
Congenital Heart Diseases in Children.pptxAshik Alvee
This document provides an overview of congenital heart disease in children. It discusses the epidemiology, risk factors, classification, and approach to diagnosis and management. Common congenital heart defects such as ventricular septal defect, atrial septal defect, patent ductus arteriosus, and tetralogy of Fallot are described in detail, including their typical presentation, physical exam findings, investigations, and treatment. The document is intended to educate medical students and trainees about pediatric congenital heart disease.
1. Acyanotic heart defects are congenital heart disorders involving left to right shunting of blood without cyanosis. Common defects include atrial septal defects (ASD) and ventricular septal defects (VSD).
2. ASDs involve an abnormal opening between the left and right atria, increasing pulmonary blood flow. VSDs involve an opening between the left and right ventricles, also increasing pulmonary flow.
3. Clinical manifestations vary depending on defect size but may include fatigue, palpitations, infections. Diagnosis involves echocardiogram, EKG, chest x-ray. Surgical repair is often recommended.
Common heart conditions in children copy.pptxRamiHaris
This document discusses common congenital and acquired heart conditions in children. It begins by describing fetal circulation and how congenital heart diseases arise from defects present at birth. The conditions are classified as acyanotic or cyanotic depending on whether they allow mixing of oxygenated and deoxygenated blood. Common acyanotic conditions discussed include atrial septal defect, ventricular septal defect, and patent ductus arteriosus. Cyanotic conditions include tetralogy of Fallot and transposition of the great vessels. The document also covers acquired conditions like rheumatic fever and infective endocarditis, as well as their presentation, diagnosis, and management.
ACYANOTIC DISEASE- Non cyanotic heart diseasesNelsonNgulube
ETIOLOGY AND EPIDEMIOLOGY
Congenital heart disease occurs in 8 per 1,000 births. The spectrum of lesions ranges from asymptomatic to fatal. Although most cases of congenital heart disease are multifactorial, some lesions are associated with chromosomal disorders, single gene defects, teratogens, or maternal metabolic disease (see Table139-2).
Congenital heart defects can be divided into three pathophysiological groups (Table 143.1).
1. Left-to-right shunts
2. Right-to-left shunts
3. Obstructive, stenotic lesions
Acyanotic congenital heart disease includes left-to-right shunts resulting in an increase in pulmonary blood flow (patent ductus arteriosus [PDA], ventricular septal defect [VSD], atrial septal defect [ASD]) and obstructive lesions (aortic stenosis, pulmonary stenosis, coarctation of the aorta), which usually have normal pulmonary blood flow.
VENTRICULAR SEPTAL DEFECTEtiology and Epidemiology
The ventricular septum is a complex structure that can be divided
into four components. The largest component is the muscular
septum. The inlet or posterior septum comprises endocardial
cushion tissue. The subarterial or supracristal septum com
prises conotruncal tissue. The membranous septum is below
the aortic valve and is relatively small. VSDs occur when any of these components fail to develop normally (Fig. 143.1). VSD,
the most common congenital heart defect, accounts for 25% of all congenital heart disease. Perimembranous VSD
Timing of Interventions in Acyanotic CHDRavi Kumar
This document discusses the timing of interventions for acyanotic heart disease in children. It covers several conditions including atrial septal defects, ventricular septal defects, patent ductus arteriosus, atrioventricular septal defects, coarctation of the aorta, aortic stenosis, and pulmonic stenosis. For each condition, it describes the typical presentation, diagnosis, natural history if left untreated, and recommendations for the ideal timing of intervention based on factors like the size of the defect, presence of heart failure or pulmonary hypertension, and age of the child. Interventions may include surgical repair, device closure, or balloon dilation depending on the specific condition and characteristics of each case. The goal is to provide evidence-based
This baby needs prostaglandin infusion urgently.
The chest X-ray shows oligemic lung fields suggesting decreased pulmonary blood flow. The clinical features of cyanosis, tachycardia, weak pulses and metabolic acidosis point towards ductal dependant circulation.
Prostaglandin infusion will help open the ductus arteriosus and improve pulmonary blood flow which is critical for survival in this neonate. Ventilator support, inotropes and antibiotics/antifungals may also be needed. An urgent echocardiogram will help identify the underlying cardiac lesion.
The key is to recognize this is not pneumonia but a ductal dependant cardiac lesion and start prostaglandin without delay.
The document discusses optimizing cardiac health through the role of physiotherapists in treating congenital heart disease. It begins with an introduction to congenital heart disease, including epidemiology and risk factors. It then covers classification of various types of congenital heart defects and their signs and symptoms. The document outlines assessment of congenital heart disease and discusses physiotherapy management and recent advancements in the field. Key congenital heart defects are explained in more detail including their characteristics, causes, and typical presentations.
This document discusses pediatric cardiac disorders, including:
1. Congenital heart defects (CHDs) are the most common birth defects and cause of infant mortality. CHDs can be acyanotic (left-to-right shunts) or cyanotic (right-to-left shunts). Common defects include atrial and ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and transposition of the great arteries.
2. Assessment of suspected CHD involves history, physical exam including pulse oximetry, chest x-ray, EKG, and echocardiogram. Major signs are systolic murmurs, diastolic murmurs, cyan
The document discusses congenital heart defects, specifically ventricular septal defects (VSD). A VSD is an opening in the ventricular septum that allows blood to pass between the left and right ventricles. VSDs are the most common type of congenital heart defect. While small VSDs may cause no symptoms, larger VSDs can lead to issues like congestive heart failure in infants. Physical exam may reveal murmurs. Treatment options include medical management or surgical closure of the defect.
This document discusses congenital heart defects, specifically atrial septal defects (ASD). It describes the types of ASDs, including ostium secundum, patent foramen ovale, and ostium primum. Clinical manifestations are typically asymptomatic for infants and children, with possible findings of a heart murmur, EKG changes, and enlarged heart on xray. Echocardiogram can diagnose and show the defect. Small defects may close on their own, while larger defects are treated with devices or surgery if causing heart failure or pulmonary hypertension. Surgical repair involves closing the defect with sutures or a patch.
The document discusses several congenital heart diseases including ventricular septal defects (VSD), atrial septal defects (ASD), patent ductus arteriosus (PDA), pulmonary stenosis, aortic stenosis, and coarctation of the aorta. It describes the pathophysiology, clinical presentation, investigations, and management of each condition. Cyanotic heart diseases are defined as those involving a right-to-left or left-to-right shunt leading to low oxygen saturation. The document provides classification, epidemiology, etiology and detailed information about specific lesions causing cyanosis.
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries.
Congenital heart disease (CHD) describes abnormalities present at birth that affect the structure and function of the heart. The most common CHDs are ventricular septal defects, atrial septal defects, tetralogy of Fallot, transposition of the great arteries, coarctation of the aorta, and patent ductus arteriosus. CHDs can cause cyanosis, heart failure, or no symptoms depending on the specific defect and severity of shunting.
approach to a bleeding child with blood disorders.pptxtsholanangmaoka
This document describes the approach to three cases of bleeding in children. Case 1 involves a 5-month-old male with intracranial bleeding and seizures who was found to have a subdural hematoma requiring surgery. Despite resuscitation efforts, the child did not survive the surgery. Case 2 is a 2-year-old male with bruising and a very low platelet count, consistent with thrombocytopenia. Case 3 involves a 1-year-old male with knee swelling and fever, who was found to have a low platelet count, consistent with disseminated intravascular coagulation. The document provides definitions of types of bleeding, the stages of hemostasis, differential diagnoses, and management strategies for bleeding
Systemic hypertension is defined as high blood pressure measured on 3 occasions. It is important to properly measure blood pressure in children using the correct cuff size based on age and arm circumference. Common causes of hypertension in children include primary hypertension, renal disease, vascular abnormalities like coarctation of the aorta, and endocrine disorders. Clinical evaluation involves taking a thorough history and physical examination to identify risk factors and look for signs of end organ damage from high blood pressure.
This document presents information from a presentation on acyanotic congenital heart disease. It begins with objectives that cover fetal circulation, defining CHD and risk factors, classifying CHD, explaining acyanotic heart disease and specific defects. It then provides detailed information on ventricular septal defect, atrial septal defect, patent ductus arteriosus, aortic stenosis, pulmonary stenosis, and coarctation of aorta. For each defect, it discusses clinical manifestation, diagnostic criteria, management, and complications. It also includes summaries of two research papers on neurodevelopmental outcomes after surgery for acyanotic CHD and a comparison of renal function between cyanotic and acyanotic CHD in children.
This document discusses several congenital heart diseases including their incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. It provides details on ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), tetralogy of Fallot, transposition of the great arteries, coarctation of the aorta, and pulmonary stenosis. The overall incidence of congenital heart diseases is about 8-10 per 1000 live births with VSD being the most common type, accounting for 25-30% of cases. Etiologies may include hereditary factors, infections, chromosomal or genetic abnormalities. Clinical exams, imaging tests, and cardiac catheterization
Congenital heart disease (CHD) refers to problems in heart structure present at birth. It affects 3-5% of births and causes up to 33% of neonatal deaths. Symptoms depend on the specific defect but may include cyanosis, difficulty breathing, and failure to thrive. Diagnosis involves a physical exam, ECG, echocardiogram, and other tests. Treatment ranges from surgery to correct defects like ventricular septal defects, patent ductus arteriosus, and tetralogy of Fallot to multi-stage procedures for single ventricle conditions like hypoplastic left heart syndrome. Nursing care focuses on nutritional support, infection prevention, reducing heart workload, monitoring for heart failure, and educating families
Pediatric dysrhythmias require careful evaluation and management based on symptoms and underlying heart conditions. Common normal variants include sinus arrhythmia and isolated premature atrial contractions. Supraventricular tachycardia is the most common abnormal rhythm requiring treatment and can often be terminated with vagal maneuvers or adenosine. Third degree atrioventricular block may require pacemaker placement depending on heart rate and symptoms. Ventricular arrhythmias are serious and may necessitate defibrillation or antiarrhythmic medication.
Congestive heart failure is a syndrome where the heart is unable to pump an adequate amount of blood to meet the body's needs. It is caused by any interference with the normal mechanisms regulating cardiac output. Common causes include hypertension, myocardial infarction, and valvular disorders. The main goals of treatment are to improve left ventricular function by decreasing preload and afterload, improving gas exchange, and enhancing cardiac contractility. Management involves diuretics, vasodilators, and other medications alongside lifestyle modifications like sodium and fluid restrictions.
This document provides information about congenital heart defects. It discusses common types of defects such as atrial septal defects, ventricular septal defects, patent ductus arteriosus, coarctation of the aorta, pulmonary stenosis, and aortic stenosis. For each defect, it describes the anatomy, causes, signs and symptoms, diagnostic evaluation, and treatment options. The document is an educational presentation that comprehensively covers several major congenital heart defects.
Congenital Heart Diseases in Children.pptxAshik Alvee
This document provides an overview of congenital heart disease in children. It discusses the epidemiology, risk factors, classification, and approach to diagnosis and management. Common congenital heart defects such as ventricular septal defect, atrial septal defect, patent ductus arteriosus, and tetralogy of Fallot are described in detail, including their typical presentation, physical exam findings, investigations, and treatment. The document is intended to educate medical students and trainees about pediatric congenital heart disease.
1. Acyanotic heart defects are congenital heart disorders involving left to right shunting of blood without cyanosis. Common defects include atrial septal defects (ASD) and ventricular septal defects (VSD).
2. ASDs involve an abnormal opening between the left and right atria, increasing pulmonary blood flow. VSDs involve an opening between the left and right ventricles, also increasing pulmonary flow.
3. Clinical manifestations vary depending on defect size but may include fatigue, palpitations, infections. Diagnosis involves echocardiogram, EKG, chest x-ray. Surgical repair is often recommended.
Common heart conditions in children copy.pptxRamiHaris
This document discusses common congenital and acquired heart conditions in children. It begins by describing fetal circulation and how congenital heart diseases arise from defects present at birth. The conditions are classified as acyanotic or cyanotic depending on whether they allow mixing of oxygenated and deoxygenated blood. Common acyanotic conditions discussed include atrial septal defect, ventricular septal defect, and patent ductus arteriosus. Cyanotic conditions include tetralogy of Fallot and transposition of the great vessels. The document also covers acquired conditions like rheumatic fever and infective endocarditis, as well as their presentation, diagnosis, and management.
ACYANOTIC DISEASE- Non cyanotic heart diseasesNelsonNgulube
ETIOLOGY AND EPIDEMIOLOGY
Congenital heart disease occurs in 8 per 1,000 births. The spectrum of lesions ranges from asymptomatic to fatal. Although most cases of congenital heart disease are multifactorial, some lesions are associated with chromosomal disorders, single gene defects, teratogens, or maternal metabolic disease (see Table139-2).
Congenital heart defects can be divided into three pathophysiological groups (Table 143.1).
1. Left-to-right shunts
2. Right-to-left shunts
3. Obstructive, stenotic lesions
Acyanotic congenital heart disease includes left-to-right shunts resulting in an increase in pulmonary blood flow (patent ductus arteriosus [PDA], ventricular septal defect [VSD], atrial septal defect [ASD]) and obstructive lesions (aortic stenosis, pulmonary stenosis, coarctation of the aorta), which usually have normal pulmonary blood flow.
VENTRICULAR SEPTAL DEFECTEtiology and Epidemiology
The ventricular septum is a complex structure that can be divided
into four components. The largest component is the muscular
septum. The inlet or posterior septum comprises endocardial
cushion tissue. The subarterial or supracristal septum com
prises conotruncal tissue. The membranous septum is below
the aortic valve and is relatively small. VSDs occur when any of these components fail to develop normally (Fig. 143.1). VSD,
the most common congenital heart defect, accounts for 25% of all congenital heart disease. Perimembranous VSD
Timing of Interventions in Acyanotic CHDRavi Kumar
This document discusses the timing of interventions for acyanotic heart disease in children. It covers several conditions including atrial septal defects, ventricular septal defects, patent ductus arteriosus, atrioventricular septal defects, coarctation of the aorta, aortic stenosis, and pulmonic stenosis. For each condition, it describes the typical presentation, diagnosis, natural history if left untreated, and recommendations for the ideal timing of intervention based on factors like the size of the defect, presence of heart failure or pulmonary hypertension, and age of the child. Interventions may include surgical repair, device closure, or balloon dilation depending on the specific condition and characteristics of each case. The goal is to provide evidence-based
This baby needs prostaglandin infusion urgently.
The chest X-ray shows oligemic lung fields suggesting decreased pulmonary blood flow. The clinical features of cyanosis, tachycardia, weak pulses and metabolic acidosis point towards ductal dependant circulation.
Prostaglandin infusion will help open the ductus arteriosus and improve pulmonary blood flow which is critical for survival in this neonate. Ventilator support, inotropes and antibiotics/antifungals may also be needed. An urgent echocardiogram will help identify the underlying cardiac lesion.
The key is to recognize this is not pneumonia but a ductal dependant cardiac lesion and start prostaglandin without delay.
The document discusses optimizing cardiac health through the role of physiotherapists in treating congenital heart disease. It begins with an introduction to congenital heart disease, including epidemiology and risk factors. It then covers classification of various types of congenital heart defects and their signs and symptoms. The document outlines assessment of congenital heart disease and discusses physiotherapy management and recent advancements in the field. Key congenital heart defects are explained in more detail including their characteristics, causes, and typical presentations.
This document discusses pediatric cardiac disorders, including:
1. Congenital heart defects (CHDs) are the most common birth defects and cause of infant mortality. CHDs can be acyanotic (left-to-right shunts) or cyanotic (right-to-left shunts). Common defects include atrial and ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and transposition of the great arteries.
2. Assessment of suspected CHD involves history, physical exam including pulse oximetry, chest x-ray, EKG, and echocardiogram. Major signs are systolic murmurs, diastolic murmurs, cyan
The document discusses congenital heart defects, specifically ventricular septal defects (VSD). A VSD is an opening in the ventricular septum that allows blood to pass between the left and right ventricles. VSDs are the most common type of congenital heart defect. While small VSDs may cause no symptoms, larger VSDs can lead to issues like congestive heart failure in infants. Physical exam may reveal murmurs. Treatment options include medical management or surgical closure of the defect.
This document discusses congenital heart defects, specifically atrial septal defects (ASD). It describes the types of ASDs, including ostium secundum, patent foramen ovale, and ostium primum. Clinical manifestations are typically asymptomatic for infants and children, with possible findings of a heart murmur, EKG changes, and enlarged heart on xray. Echocardiogram can diagnose and show the defect. Small defects may close on their own, while larger defects are treated with devices or surgery if causing heart failure or pulmonary hypertension. Surgical repair involves closing the defect with sutures or a patch.
The document discusses several congenital heart diseases including ventricular septal defects (VSD), atrial septal defects (ASD), patent ductus arteriosus (PDA), pulmonary stenosis, aortic stenosis, and coarctation of the aorta. It describes the pathophysiology, clinical presentation, investigations, and management of each condition. Cyanotic heart diseases are defined as those involving a right-to-left or left-to-right shunt leading to low oxygen saturation. The document provides classification, epidemiology, etiology and detailed information about specific lesions causing cyanosis.
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries.
Congenital heart disease (CHD) describes abnormalities present at birth that affect the structure and function of the heart. The most common CHDs are ventricular septal defects, atrial septal defects, tetralogy of Fallot, transposition of the great arteries, coarctation of the aorta, and patent ductus arteriosus. CHDs can cause cyanosis, heart failure, or no symptoms depending on the specific defect and severity of shunting.
approach to a bleeding child with blood disorders.pptxtsholanangmaoka
This document describes the approach to three cases of bleeding in children. Case 1 involves a 5-month-old male with intracranial bleeding and seizures who was found to have a subdural hematoma requiring surgery. Despite resuscitation efforts, the child did not survive the surgery. Case 2 is a 2-year-old male with bruising and a very low platelet count, consistent with thrombocytopenia. Case 3 involves a 1-year-old male with knee swelling and fever, who was found to have a low platelet count, consistent with disseminated intravascular coagulation. The document provides definitions of types of bleeding, the stages of hemostasis, differential diagnoses, and management strategies for bleeding
Systemic hypertension is defined as high blood pressure measured on 3 occasions. It is important to properly measure blood pressure in children using the correct cuff size based on age and arm circumference. Common causes of hypertension in children include primary hypertension, renal disease, vascular abnormalities like coarctation of the aorta, and endocrine disorders. Clinical evaluation involves taking a thorough history and physical examination to identify risk factors and look for signs of end organ damage from high blood pressure.
This document presents information from a presentation on acyanotic congenital heart disease. It begins with objectives that cover fetal circulation, defining CHD and risk factors, classifying CHD, explaining acyanotic heart disease and specific defects. It then provides detailed information on ventricular septal defect, atrial septal defect, patent ductus arteriosus, aortic stenosis, pulmonary stenosis, and coarctation of aorta. For each defect, it discusses clinical manifestation, diagnostic criteria, management, and complications. It also includes summaries of two research papers on neurodevelopmental outcomes after surgery for acyanotic CHD and a comparison of renal function between cyanotic and acyanotic CHD in children.
This document discusses several congenital heart diseases including their incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. It provides details on ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), tetralogy of Fallot, transposition of the great arteries, coarctation of the aorta, and pulmonary stenosis. The overall incidence of congenital heart diseases is about 8-10 per 1000 live births with VSD being the most common type, accounting for 25-30% of cases. Etiologies may include hereditary factors, infections, chromosomal or genetic abnormalities. Clinical exams, imaging tests, and cardiac catheterization
Congenital heart disease (CHD) refers to problems in heart structure present at birth. It affects 3-5% of births and causes up to 33% of neonatal deaths. Symptoms depend on the specific defect but may include cyanosis, difficulty breathing, and failure to thrive. Diagnosis involves a physical exam, ECG, echocardiogram, and other tests. Treatment ranges from surgery to correct defects like ventricular septal defects, patent ductus arteriosus, and tetralogy of Fallot to multi-stage procedures for single ventricle conditions like hypoplastic left heart syndrome. Nursing care focuses on nutritional support, infection prevention, reducing heart workload, monitoring for heart failure, and educating families
Pediatric dysrhythmias require careful evaluation and management based on symptoms and underlying heart conditions. Common normal variants include sinus arrhythmia and isolated premature atrial contractions. Supraventricular tachycardia is the most common abnormal rhythm requiring treatment and can often be terminated with vagal maneuvers or adenosine. Third degree atrioventricular block may require pacemaker placement depending on heart rate and symptoms. Ventricular arrhythmias are serious and may necessitate defibrillation or antiarrhythmic medication.
Congestive heart failure is a syndrome where the heart is unable to pump an adequate amount of blood to meet the body's needs. It is caused by any interference with the normal mechanisms regulating cardiac output. Common causes include hypertension, myocardial infarction, and valvular disorders. The main goals of treatment are to improve left ventricular function by decreasing preload and afterload, improving gas exchange, and enhancing cardiac contractility. Management involves diuretics, vasodilators, and other medications alongside lifestyle modifications like sodium and fluid restrictions.
The document discusses various types of congenital heart disease including acyanotic lesions that involve left-to-right shunts such as atrial septal defects, ventricular septal defects, atrioventricular septal defects, and patent ductus arteriosus. It describes the anatomy, clinical presentation, diagnostic findings, and treatment options for each condition. Key information provided includes descriptions of murmurs caused by various defects and genetic syndromes that are commonly associated with certain heart lesions.
Paediatric Cardiology for General Paediatrics.pptSalam467227
This document provides an overview of paediatric cardiology for general paediatricians. It discusses how to evaluate ECGs by assessing rhythm, rate, intervals, waves and axes. Common causes of syncope are also reviewed, including vasovagal, orthostatic, and cardiac causes. Long QT syndrome is discussed in detail. The pathophysiology of various congenital heart lesions such as atrial and ventricular septal defects, patent ductus arteriosus, atrioventricular septal defect, and cyanotic lesions are outlined. Tips are provided to read more ECGs and ask for help when needed.
This document provides guidance on pediatric EKG interpretation. It discusses the key steps and aspects to analyze when reading a pediatric EKG, including rhythm, rate, QRS axis, intervals, hypertrophy, ST segments, T waves, and electrical heart diseases. Supraventricular tachycardia is highlighted as the most common tachyarrhythmia in childhood, with some cases being asymptomatic and others potentially leading to poor left ventricular function if not treated appropriately.
This document discusses infective endocarditis (IE) in pediatrics. It covers the epidemiology, pathogenesis, microbiology, diagnosis, treatment, prevention, and prognosis of IE. Some key points include:
- IE mortality has decreased from nearly 100% pre-antibiotics to 15-25% currently. Risk factors include congenital heart disease and prosthetic valves.
- Endothelial damage from trauma or infection allows platelet/fibrin deposition and bacterial colonization on heart valves, leading to IE.
- Common causative organisms are viridans streptococci, staphylococci, and HACEK bacteria. Diagnosis utilizes modified Duke criteria including blood cultures and echocardiogram
This document provides an overview of heart murmurs, including their pathophysiology, description, timing, location, and associated conditions. It discusses systolic murmurs such as those from aortic stenosis and mitral regurgitation. It also reviews diastolic murmurs like aortic regurgitation and mitral stenosis. Continuous murmurs from conditions like patent ductus arteriosus are also summarized. The document aims to help clinicians characterize and diagnose heart murmurs based on key attributes.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. Cardiac Disorders in Peds
Two major groups of disorders:
Congenital
Aka “born with”
Most structural defects
Acquired
Develop later in life
Bacterial endocarditis
Rheumatic fever
Kawasaki disease
Systemic HTN
3. Incidence & Causes
5 to 8 in 1000 live births
Cause unknown
Multiple factors
Genetics/family history
Environment
Toxins
Viruses
Maternal chronic illness (diabetes, seizure meds)
Chromosomal abnormalities
Down syndrome
DiGeorge syndrome
Noonan or William syndrome
Trisomy 13 or 18
4. Older Classifications of CHD
Acyanotic
“pink”
NO unoxygenated blood goes to the periphery
Cyanotic
“blue”
Unoxygenated blood is shunted to the periphery
May be pink
5. Newer Classifications of CHD
Hemodynamic characteristics
Increased pulmonary blood flow
Too much to lungs; “pink”; pulmonary edema
Decreased pulmonary blood flow
Too little to lungs; “blue”; cyanotic
Obstruction of blood flow out of the heart
Can’t get to lungs or body
Mixed blood flow
Most common
6. Comparison of CHD Classification Systems—
p.1276 10th ed. Hockenberry
7. Background info/Hemodynamics
Review fetal to neonatal circulation (pp. 1342-1343
Hockenberry, 9th ed.; pp. 1252-1253, 10th ed.) See Khan Academy links on
Course Calendar.
Blood flows from area of high pressure to one of low
pressure (Fig. 34-7 p. 1351 Hockenberry, 9th ed.; Fig. 29-7 p. 1262, 10th ed.)
The greater the pressure gradient, the greater the rate of
flow.
The greater the resistance, the lower the rate of flow
In the NORMAL HEART, pressures on the R side are less
than the L side, and the resistance in the pulmonary
circulation is less than that in the systemic circulation.
11. Rahi, A., Grosse, SD, Ailes, EC, Oster, ME. Association of US State Implementation
of Newborn Screening Policies for Critical Congenital Heart Disease With Early
Infant Cardiac Deaths. JAMA. 2017;318(21):1-8.
Main Findings from this Study—Critical Congenital Heart
Disease Screening mandated in certain states.
A 33% decline in infant deaths from CCHD and a 21% decline in
infant deaths from other or unspecified cardiac causes were
observed in eight states with mandated and implemented
screening policies compared to states without mandated
screening policies.
Adoption of other screening policies (voluntary policies or
mandatory policies not yet implemented) was not associated
with reductions in infant deaths.
Mandatory screening policies applied nationwide are
projected to save about 120 babies each year.
13. Tests of cardiac function
Prenatal ultrasound
Chest x-ray
Electrocardiogram (ECG)
Echocardiogram
Cardiac catheterization
Stress test (dobutamine
or exercise)
Cardiac MRI
14. Cardiac Catheterization
Invasive routine diagnostic procedure
Benefits
Better visualization
Actual pressures, sats, hemodynamic values
Risks:
Hemorrhage
Fever
N/V
loss of a pulse
transient dysrhythmias
15. Nursing interventions for Cardiac Catheterization
(pp.1348-9 , 9th ed., pp. 1258-60, 10th ed. Hockenberry)
Pre-procedure:
Complete a thorough hx & physical exam
Check for allergies to iodine and shellfish
age appropriate teaching & preparation
Don’t forget the parents
NPO 4-6 hrs before procedure; sedation~ IV or po
Monitor VS, SaO2, Hgb, Hct, coags, BMP
Mark pedal pulses—before procedure to ensure correct palpation
afterwards.
Determination the amount of sedation based on the child’s age,
condition & type of procedure
16. Cardiac Catheterization
Post-procedure:
√ for bleeding at site of insertion of catheter in groin
√ pulses esp. distal to site of insertion, temp & color of extremities,
VS q 15
Remember the 5 P’s (pain, pallor, pulse, paresthesia, paralysis)
OR CMTS—circulation, mobility, temperature, sensation
√ heart rate for one full minute, for signs of dysrhythmias or
bradycardia
Prevent bleeding by keeping leg immobilized for 4-8 hrs
I & O, especially O. Fluids may be offered po starting with clear
liquids.
√ Labs; infants are at risk for hypoglycemia—monitor blood glucose
as child may need IV with dextrose
Encourage the child to void to promote excretion of contrast
medium.
17. Cardiac Catheterization (cont’d)
Potential cardiac catheterization complications:
Nausea &/or vomiting
Low-grade fever
Loss of pulse in catheterized extremity
Transient dysrhythmias
Acute hemorrhage from entry site
apply direct continuous pressure at 2.5cm above the catherter
entry site to localize pressure over the location of the vessel
puncture.
Keep child flat and notify the physician
Prepare for possible administration of additional fluids prn
20. Symptoms of CHF
Increased work of
breathing
Tachycardia
Decreased pulses
Decreased urinary output
Poor weight gain
Diaphoresis with activity
Hepatomegaly
Cold, cool extremities,
especially with stress or
activity
JVD?
Decreased BP is LATE
sign
21. Defects with Increased Pulmonary Blood Flow
Abnormal connection
between two sides of heart
leads to
Increased blood volume on
right side of heart
Increased pulmonary
blood flow
Decreased systemic blood
flow
PDA, ASD, VSD
Symptoms
Increased work of
breathing
Rales/rhonchi
and/or wheezing
Failure to thrive
22. Patent Ductus Arteriosus
Ductus doesn’t close
Common in preemies
“machinery” murmur
audio
Treatment
Indomethacin
Cath lab
Ligation
23. Atrial Septal Defect
Hole between two atria of
heart
Usually asymptomatic
If not treated, increased
risk of atrial dysrhythmia
or stroke
Usually close on own
24. Ventricular Septal Defect
Hole between two
ventricles of heart
Symptoms related to size
& location of VSD and
amount of pulmonary
blood flow
Fix by patching with
Goretex
25. Atrioventricular Canal
ASD, VSD, and affected
mitral & tricuspid valves
Associated with Down
syndrome
Symptoms related to size
of holes, degree of
valvular involvement, &
size of ventricles
Often accompanied with
pulmonary hypertension
26. Nursing Management
AVOID OXYGEN!!!!!!!!—
use judiciously
Especially pre-op
Diuretics—furosemide,
chlorothiazide,
spironolactone
Monitor VS, I & 0, daily wt.
Encourage rest periods to
conserve energy
Monitor labs: Hgb, Hct,
electrolytes
Closely monitor feedings
May need higher calorie
feeds
28. Coarctation of Aorta
Narrowed aorta leads to
decreased systemic blood
flow
May not present until
early childhood
Bounding upper
extremity pulses, weak to
absent lower extremity
pulses
HYPERTENSION!!!!!!!
30. Aortic stenosis
Obstructs blood flow to
body
Leads to left ventricle
hypertrophy
Asymptomatic often
Chest pain with exercise
Sometimes see sudden
death
Repair with ballooning,
repair, or replacement of
valve
31. Pulmonary Stenosis and Catheter Placement
Leads to right ventricular hypertrophy
which may lead to reopening of the
foramen ovale. If severe, my lead to
congestive heart failure.
32. Defects with Decreased Pulmonary Blood
Flow and Mixed Defects
May or may not be cyanotic (usually are)
Tetralogy of Fallot
Transposition of Great Arteries
Truncus Arteriosus
Hypoplastic Left Heart Syndrome (HLHS)
LOTS of other defects that are uncommon, book
discusses them
33. Effects of Hypoxemia
Main clinical manifestations:
Cyanosis
Polycythemia
Thicker blood
Clubbing
Clotting abnormalities
Delayed growth and development – can be associated
with any heart defect
34. Hypoxemia Management
Prostaglandin E1 given if cyanosis
shown as newborn
Assess for and treat tet spells
Surgery
Corrective or palliative—often staged
Prevent dehydration
AVOID OXYGEN!!!!!
36. Hypercyanotic “tet spells”
Acutely cyanotic
↓ pulm. blood flow & ↑ right to left shunting
Prompt tx to prevent brain damage &/or death
Calm infant/child
Place in knee chest position
Toddler will get in “squatting” position to compensate
for hypoxia
Give oxygen
Morphine/fentanyl/versed given
39. Tet Repair
Complicated
Dependent on how big
RV is, how stenotic
pulmonic valve is, and
how big the VSD is
Either fly or die
Palliative shunt: modified
Blalock-Taussig shunt
(p.1364, Table 34-4, 9th ed.
Fig. 29-11, p.1274, 10th ed.)
Complete repair—
operative mortality <3%!
40. Transposition of the Great Arteries
NOT GOOD!
Cath lab initially
Prostaglandins
Surgery at 6-7 days old—
arterial switch of pulmonary
artery and aorta, but also
coronary arteries are switched
and re-anastomosed.
Long term prognosis very good
41. Hypoplastic Left Heart Syndrome
VERY VERY VERY BAD!! However--Survival rates have
changed dramatically in the last 15 years. Can be has high as 95%
Can not correct easily—parents must choose…
3 staged surgeries: Norwood, Mod Blalock Taussig, & Glenn
procedure vs. transplant
Long-term data not in yet, will probably need transplant
42. Management of Children with Mixed Defects
Medications
Digoxin—KNOW!! pp.1354-
1358, 9th ed. P.1269-70, 10th ed.—
good info on meds
Improves contractility of heart
Review dig toxicity—pulse rates
in infants & children
Diuretics—furosemide
Watch for what ??
Ace-inhibitors (angiotensin
converting inhibitors—the
PRIL’s)
Reduce afterload on the heart
make heart pump more
efficiently.
Beta-blockers—cause
decreased heart rate, BP *
vasodilatation
Decrease cardiac
workload
Meds-as stated
Decrease stimulation
Cluster care
Maintain neutral thermal
environment
Sedation for irritable child
Remove accumulated
fluid & sodium
Closely monitor I&O
Restrict fluid in acute phase
Weigh daily if stable
43. Continued management of CHF
Nutrition
Smaller, more frequent
feeds
High calorie formula
Decrease respiratory
effort
Rest
Avoid colds, RSV
Position with HOB
Avoid crying and distress
Family support/education
Keep them present,
holding, rocking, AMAP
Improve tissue
oxygenation
Meds assist with this by
increasing efficiency of the
heart
Oxygen may be added with
appropriate order,
especially if there is
pulmonary edema, or lower
respiratory infection.
44. Post-operative Care
PAIN!!!!!!!!!!!!!!!!!!!
Cardiac monitoring
Heart rate
Blood pressure
Intracardiac pressures
Chest tube care
Quantity & quality of
output
Urine output
Minimum 1 ml/kg/hour
Neurological checks
Move all extremities
Back to baseline
Respiratory care
Deep breathing
IS
Rest & activity
Up next day
Ambulate
GI distress
Avoid vomiting
45. Care of the Family and Child with
Congenital Heart Disease
Help family adjust to the disorder
May be grieving loss of normal child
Educate family
Help family cope with effects of the disorder
Prepare child and family for surgery
Remember developmental level of child
Pain, scars, IS, activity
Refer to support group with families who have already been through
the experience
TOUCH is the IL Assoc. This link opens a broad site, then click on
IL.
Congenital Heart Information Network: lots of links for families
and persons with CHD
Website: From Cincinnati Children’s Hospital
46. Kawasaki Disease
Multisystem disorder involving vasculitis & may
progress to coronary arteries causing
aneurysm formation
Leading cause of acquired heart dz in US
Etiology still unknown
3 phases:
acute
subacute
convalescent
47. Criteria for KD (must meet 5 out of 6)
Box 34-10, p. 1388, Hockenberry (9th ed); Box 29-9,
p. 1299 (10th ed.)
fever > 5 days
conjunctival infection without exudate
oral changes: erythema, “strawberry tongue,
fissured lips
extremities changes: peripheral edema, erythema of
palms and soles, peeling of hands & feet
erythematous rash
cervical lymphadenopathy
48. Other manifestations
Symptoms of inflammation
C reactive protein level
ESR
Cardiac symptoms
L ventricular function as seen on Echocardiogram
Children do NOT generally have sx of CHF
Other lab changes
Anemia
Leukocytosis with ‘L shift’
49. Kawasaki continued
Tx best within first 7- 10 days. :
ASA 80-100mg/kg/day initially.
This is one dx that requires use of high doses of aspirin
even in children. Dose is decreased to 3-5 mg/kg/day
once afebrile 48-72 hrs.
IVIG 2 g/kg over 8-12 hr
Here is a website with some good information on the
diagnosis and management of this disease:
http://www.kdfoundation.org/
50. Newburger, J. W. et al. Circulation 2004;110:2747-2771
From the
American Heart
Association
p. 1300
10th ed.
51. Education of parents
Teach parents common signs of Aspirin toxicity while
on high doses of ASA
Tinnitus
Headache
Dizziness
Confusion
Teach parents to report recurrence of fever
Teach parents CPR
Inform parents that final cardiac sequelae may not be
known for some time.