Notes in 03b. Pediatric Congenital Heart Dz in Primary Care

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Published	06/26/2023	Congenital Heart Dz Stats Congenital Heart Dz around 1% of pop includes everything from VSD to complex Causes Multi-Factoralr…
Published	06/26/2023	kids and murmurs look before you listen (inspection) healthy appearance or chronically ill? Height, weight RR and pattern {{c…
Published	06/26/2023	Kids and Murmurs profitable palpation (Palpation) Precordial activity → heave, thrill, PMI Pulses → {{c1::both arms, one leg}…
Published	06/26/2023	kids and murmurs systolic murmurs Ejection → {{c1::PS, AS, functional}}holosystolic → {{c1::VSD,, MR and TR}}diastolic AI, PI…
Published	06/26/2023	normal murmurs → think {{c1::water hose}}venous hums {{c1::pulmonary}} flow → RV to MPA MPA to branch PA {{c1::Still's}} murmur&nb…
Published	06/26/2023	Who should be referred? child w/ a murmur not clearly normal or abnormal ECG child w/ {{c1::down's}} (50%) or marfan's syndrome ch…
Published	06/26/2023	CHF Definition heart is unable to pump blood to meet its needs → actually working {{c1::overtime}}signs and symptoms sweating, poo…
Published	06/26/2023	different pulses between upper and lower extremities → {{c1::CoA}}different pulses between L arm and R arm → {{c1::Subclavian Steal}}
Published	06/26/2023	CHF volume overload MC in infants → {{c1::VSD, PDA, AV canal}}treatment Diuretics, inotropic agents, afterload reducing agents
Published	06/26/2023	Medications for {{c3::CHF}} lasix → {{c1::furosemide}}Digoxin → {{c1::digitalis}}ACE inhibitors → {{c1::-pril}}Milrinone → used in…
Published	06/26/2023	Atrial Septal Defect (ASD) as isolated lesion, rarely causes problems in children may spontaenously close adults have risk of stroke, a…
Published	06/26/2023	atrial septum types of defects Secundum primum → {{c1::lower}} part of septum. canal defect. part of AAVSD, always have cleft in M…
Published	06/26/2023	CHF is considered a {{c1::left to right}} shunt
Published	06/26/2023	Murmur grading
Published	06/26/2023	heaving → {{c1::feeling}} the heart beats thrill → feels like a {{c1::drier}}
Published	06/26/2023	ventricular septum {{c1::left to right}} → increased flow to the lungs depending on size close spontaenously, usually within the first …
Published	06/26/2023	AV canal AVSD → endocardial {{c1::cushion}} defect often associated w/ {{c1::Down's}}Consist of Primum {{c1::atrial septal de…
Published	06/26/2023	AV canal heart failure develops in first few months → worse in non-down syndrome pts murmur may be hard to hear → if present can be {{c…
Published	06/26/2023	atrial septum → hole through the {{c1::top two chambers}} of the heart
Published	06/26/2023	LVOT Bicuspid aortic valves increased risk of {{c1::AI/AS}}Shrone's complex serial left heart obstructive lesions {{c2::Mitral valve, L…
Published	06/26/2023	Coarctation of the Aorta difficult to pick up prenatally clinically can present in {{c1::cardiac shock}}has different pulses in upper a…
Published	06/26/2023	{{c1::ASD}} or previous {{c1::heart}} surgery → two most common reasons for abnormality on EKG in children
Published	06/26/2023	{{c1::COA}} typically treated surgically in first few weeks of life → end to end anastomosis may renarrow and require intervention if d…
Published	06/26/2023	most common congenital heart disease → {{c1::VSD}}
Published	06/26/2023	Aortic stenosis
Published	06/26/2023	PDA aortopulmonary collateral → connects {{c1::aorta}} and {{c1::pulmonary artery}}life saving in ductal-dependent CHD more common…
Published	06/26/2023	MC VSD → {{c1::Muscular VSD}} but try to avoid closing {{c1::Perimembranous}} VSD → most concerning → two walls forget to close in embryo → …
Published	06/26/2023	PDA graphic
Published	06/26/2023	pt scenario for HF 5 day old presents for new baby visit term infant w/ {{c3::uncomplicated delivery}} D/C normally slight murmur at D/…
Published	06/26/2023	HF is worse in {{c2::non-Down syndrome pts}}
Published	06/26/2023	most PDA's close within first 48 hours but can be good in {{c1::Congenital Heart Disease}}
Published	06/26/2023	What should you be thinking?
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