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Pediatric Cardiology Basics
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Tricuspid Atresia
Absence of the tricuspid valve, preventing blood flow from the right atrium to the right ventricle. Manifestations include cyanosis, dyspnea, and fatigue. Treated with a series of surgeries culminating in the Fontan procedure.
Rheumatic Heart Disease
A complication of rheumatic fever that causes valve damage. Manifestations include murmurs, heart failure, and joint pain. Treatments focus on preventing further damage with antibiotics and potential valve repair or replacement.
Pulmonary Hypertension
High blood pressure in the arteries of the lungs. It can be idiopathic or secondary to other heart defects. Manifestations include shortness of breath, dizziness, and chest pain. Managed with medications, oxygen therapy, and sometimes lung transplantation.
Cardiomyopathies
A group of diseases that affect the heart muscle. Can be dilated, hypertrophic, or restrictive. Manifestations include fatigue, shortness of breath, and irregular heartbeats. Treatment varies but can include medications, lifestyle changes, and heart transplantation.
Total Anomalous Pulmonary Venous Return (TAPVR)
Pulmonary veins drain into the right atrium instead of the left atrium. Manifestations include cyanosis, respiratory distress, and failure to thrive. Requires surgical repair to connect the pulmonary veins to the left atrium.
Coarctation of the Aorta
A narrowing of the aorta that impedes blood flow. Manifestations include hypertension in the arms, weak or absent leg pulses, and heart murmur. Treated by catheter-based interventions or surgery to relieve the narrowing.
Pulmonary Stenosis
Narrowing at or near the pulmonary valve, obstructing blood flow from the right ventricle to the pulmonary artery. Manifestations include a heart murmur, cyanosis, and right ventricular hypertrophy. Treatments include balloon valvuloplasty or surgical repair.
Patent Ductus Arteriosus (PDA)
The ductus arteriosus fails to close after birth, resulting in abnormal blood flow between the aorta and pulmonary artery. Manifestations include murmur, poor weight gain, and easy fatiguability. Treatment options include NSAIDs, catheter-based procedures, or surgery.
Kawasaki Disease
An acute vasculitis that can affect coronary arteries. Manifestations include fever, rash, and swollen lymph nodes. Treatment includes intravenous immunoglobulin (IVIG) and aspirin to reduce coronary artery complications.
Endocarditis
Infection of the heart valves or endocardium. Manifestations include fever, heart murmur, and petechiae. Treatment involves lengthy courses of antibiotics and sometimes surgery to repair or replace damaged valves.
Atrial Septal Defect (ASD)
A hole in the septum between the heart's two upper chambers. Manifestations include difficulty breathing, frequent respiratory infections, and heart murmurs. Potential treatments include monitoring, medication, and surgical closure of the defect.
Hypoplastic Left Heart Syndrome (HLHS)
Underdevelopment of the left side of the heart, resulting in an inadequate systemic circulation. Manifestations include cyanosis, lethargy, and cold extremities. Managed with a staged surgical approach or heart transplantation.
Long QT Syndrome
A condition affecting the heart's electrical recharging system. Manifestations include arrhythmias, fainting, and in severe cases, sudden cardiac death. Treated with beta-blockers, lifestyle changes, and potentially an implantable defibrillator.
Transposition of the Great Arteries
The aorta and pulmonary artery are switched, leading to two separate circuits (systemic and pulmonary), which is incompatible with life without mixing of blood. Manifestations include cyanosis and heart failure. Requires surgical correction such as the arterial switch operation.
Congenital Heart Block
A defect in the heart's electrical system, resulting in a disrupted conduction between atria and ventricles. Manifestations include bradycardia, fatigue, and in severe cases, cardiac arrest. Treated with a pacemaker if symptomatic.
Heart Murmurs
Sounds during heartbeat cycle made by turbulent blood in or near the heart. They can be innocent or indicate heart defects. Murmurs are categorized by timing, duration, and intensity. Workup may include echocardiography and potential intervention based on the underlying cause.
Ventricular Septal Defect (VSD)
An opening in the ventricular septum which lets blood pass from the left to the right ventricle. Manifestations include a loud heart murmur, poor feeding, and failure to thrive. Treatments range from non-surgical watchful waiting to surgical repair.
Tetralogy of Fallot
A congenital heart defect with four components: VSD, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. Manifestations include cyanosis, clubbing of fingers, and squatting during episodes of cyanosis. Treatment is surgical repair.
Fetal Circulation
Circulation pattern in the fetus includes unique structures like the ductus arteriosus and foramen ovale, which normally close after birth. Allows the blood to bypass the lungs, which are not used until after birth. Changes occur at birth to shift to adult circulation.
Eisenmenger Syndrome
Occurs when left-to-right shunts (e.g., VSD, ASD, PDA) lead to pulmonary hypertension, causing the shunt to reverse to a right-to-left shunt. Manifestations include cyanosis, shortness of breath, and exercise intolerance. Managed with oxygen therapy and medications to reduce pulmonary pressures.
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