DID YOU KNOW A BABY IS BORN WITH A CONGENITAL CARDIAC DEFECT EVERY 15 MINUTES?

Objectives

List the general signs and symptoms of congenital heart disease
Differentiate between patent ductus arteriosus, coarctation of the aorta, atrial and ventricular septal defects and tetralogy of fallot.
Discuss statistics related to congenital heart defects in the US.

Statistics related to Congenital Cardiac Defects

 Most common type of birth defect.

 Leading cause of infant death.

 Present among nearly 40,000 births in the United States each year.

 Congenital heart defects in the U.S cost about $1.4 billion in 2014

 2005, estimated medical care costs for an infant with any congenital heart defect was nearly $100,000

cdc.gov

Congenital Cardiac Defects are categorized as Acyanotic or Cyanotic depending on whether or not the child will manifest cyanosis due to the abnormal shunting of blood through the the defect.

ACYANOTIC

Left to Right shunting of blood

 Patent Ductus Arteriosus

 Coarctation of the aorta

 Septal Defects

CYANOTIC (These disorders begin with 'T')

Right to left shunting of blood

 Tetralogy of Fallot

 Transposition of

the Great Arteries

Patent Ductus Arteriosus

 Fetal vessel

 Shunts blood from pulmonary artery to aorta

 Fetal blood bypasses lungs

 Normally, closes spontaneously shortly after birth

Signs and Symptoms

Tachypnea and Dyspnea with feeding

 Frequent respiratory

infections

 Characteristic machine

type murmur

Treatment

Indomethacin

 “Umbrella” cardiac

catheter

 Pulmonary ductus ligation surgery

Coarctation of the Aorta

Narrowed descending aorta

 Increased blood flow and pressure (above the narrowing)

 Bounding radial pulses, dyspnea, HA, epistaxis, dizziness, HTN upper extremities have increased blood flow

 Decreased circulation to lower extremities, Leg cramps, diminished/absent peripheral pulses, cooler, lower extremities

 BP & P higher in Upper Extremity, lower in Lower Extremities

Surgery-aorta enlarged with flap from

subclavian artery

 No BP, phlebotomy, IV to left arm post surgery

Atrial Septal Defect-Hole in wall separating right and left atria

Ventricular Septal Defect-Hole in wall separating ventricles

 Loud harsh murmur

 Excess blood to lungs

 Dyspnea with feeding

 Tachycardia, delayed cap refill

 Pulmonary edema & CHF are complications

 Digoxin and Diuretics

 Open heart surgery (patch) or trans catheter repair necessary

Tetralogy of Fallot

 Overriding Aorta

 Pulmonic stenosis

 VSD

 Right Ventricular Hypertrophy

 Cyanosis 88-92% O2 Sat

Clubbing of the fingers

 Polycythemia

 Failure to Thrive

Tet/hpercyanotic Spell

For tet Spells:

 Oxygen

 Morphine

 IV fluids

Knee chest (infant)/squatting position(older)

 Surgery-connecting subclavian artery to pulmonary artery (palliative)

 Curative-Repair of pulmonic valve

 VSD closure

 Lasix

 Digoxin

References

 Centers for Disease Control and Prevention. (2014). Congenital Heart Defects. Data and Statistics in the United States.

Retrieved 2/19/14. Available at

http://www.cdc.gov/ncbddd/heartdefects

/data.html

Leifer, G. (2010). Introduction to Maternity and Pediatric Nursing (6th ed.). St. Louis, MO: Saunders

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