Heart defects that increase pulmonary BF (L-R shunt)

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Heart defects that increase pulmonary BF (L-R shunt) により Mind Map: Heart defects that increase pulmonary BF (L-R shunt)

1. VSD (Ventricular Septal Defect)

1.1. opening in ventricles

1.2. systolic murmur heard at 3rd/4th L intercostal space @ sternal border

1.2.1. thrill present

1.3. small VSDS= no s/s

1.4. large VSDS = CHF, poor growth, decrease exercise intolerance, increased pulmonary infections/HTN

1.5. down syndrome pts

1.6. DX: CXR, ECG

1.6.1. CXR for large opening= enlarged heart and pulmonary vascular markings w/shunting

1.7. should usually close within 6 months

1.7.1. If unable to close, surgery at 6 months-1 y/o unless CHF cannot be managed

1.8. TX: surgery, cardiac cath, pacemaker

1.8.1. Complications: arrhthymias, infection, R branch block or heart block

2. ASD (Atrial Septal Defect)

2.1. opening between atriums

2.2. soft systolic ejection murmur

2.3. listen for S2 splitting @ pulmonary area

2.4. asymptomatic

2.5. no activity limitations

2.6. large ASD risk for CHF, poor growth, tire easily, arrythmias, pulmonary artery HTN

2.7. DX: enlarged R ventricle by accident

2.8. Cardiac catheterization, surgery w/occlude, aspirin 81 mg post op

2.9. Middle aged adults w/no tx risk for stroke d/t PE

2.10. seen in down syndrome pts

3. PDA (Patent Ductus Arteriosus)

3.1. cause: persistent fetal circulation in premies (< 37 weeks)

3.2. "machinery" murmur/thrill in pulmonic area

3.3. normal for newborns ductus to close by 2-3 days -> PDA if it doesn't close during this time.

3.4. TX: surgery @ 2-4 months for mitral valve replacement/patch, transcatheter closure, thorascopic surgery/clip ligation, IV ibuprofen and indomethacin to close PDA (don't use if CHF present/term infants)

3.5. risk for respiratory infections/pneumonia

3.6. asymptomatic

3.6.1. if symptomatic you will see tachypnea, tachycardia, full bounding pulses, intercostal retractions, poor growth, CHF, (large PDA)

3.7. DX: CXR, ECG- left ventricular hypertrophy

3.8. connection of aorta and pulmonary artery

3.9. no long term complications

4. S/s for all: tachypnea, tachycardia, CHF, acrocyanosis ( pink baby