Workshop B: Essentials of Neonatal Cardiology and CHD Anthony C. Chang, MD, MBA, MPH CARDIAC INTENSIVE CARE

Size: px
Start display at page:

Download "Workshop B: Essentials of Neonatal Cardiology and CHD Anthony C. Chang, MD, MBA, MPH CARDIAC INTENSIVE CARE"

Transcription

1 SHUNT LESIONS NEONATAL : CONGENITAL CARDIAC MALFORMATIONS AND CARDIAC SURGERY ANTHONY C. CHANG, MD, MBA, MPH CHILDREN S HOSPITAL OF ORANGE COUNTY ATRIAL SEPTAL DEFECT LEFT TO RIGHT SHUNT INCREASED PULMONARY FLOW RV VOLUME OVERLOAD ATRIAL DYSRHYTHMIAS ATRIAL SEPTAL DEFECT PARTIAL ANOMALOUS PV RETURN LV-RA SHUNT (GERBODE DEFECT) CA-RA FISTULA CEREBRAL AVM VENTRICULAR SEPTAL DEFECT LEFT TO RIGHT SHUNT INCREASED PULMONARY FLOW AND PRESSURE LV VOLUME OVERLOAD VENTRICULAR SEPTAL DEFECT PATENT DUCTUS ARTERIOSUS AORTOPULMONARY WINDOW 1

2 COMMON ATRIOVENTRICULAR CANAL COMMON MIXING INCREASED PULMONARY BLOOD FLOW AND PRESSURE AV VALVE REGURGITATION BIVENTRICULAR VOLUME OVERLOAD COMMON ATRIOVENTRICULAR CANAL PAP PBF PVR PAP PBF PVR Low Normal Low CDH Normal or Low PAP PBF PVR PAP PBF PVR CDH Normal or Low VSD Normal VSD in Premie Low 2

3 PAP PBF PVR VSD in Premie VSD in Neonate Low Normal OBSTRUCTIVE LESIONS PULMONARY STENOSIS TETRALOGY OF FALLOT PREOPERATIVE PHYSIOLOGY UNRESTRICTIVE VSD DYNAMIC RVOT OBSTRUCTION RV HYPERTROPHY R TO L SHUNT WITH DECREASE IN SVR TETRALOGY OF FALLOT PREOPERATIVE PHYSIOLOGY TOF AND WITH STENOTIC SHUNT DORV WITH SUBPS SV WITH SUBPS ANY SV WITH STENOTIC SHUNT TREAT WITH OXYGEN, VOLUME, AND NEOSYNEPHRINE 3

4 TETRALOGY OF FALLOT/PULMONARY ATRESIA TETRALOGY OF FALLOT/ ABSENT PULMONARY VALVE AORTIC STENOSIS LV PRESSURE OVERLOAD LV CONCENTRIC HYPERTROPHY SUBENDOCARDIAL ISCHEMIA COEXISTING LESIONS AORTIC STENOSIS CORONARY ISCHEMIA ROSS LV DYSFUNCTION NEOAORTIC INSUFFICIENCY RV DYSFUNCTION RESIDUAL VSD RVOT NARROWING ROSS-KONNO COARCTATION OF THE AORTA LV PRESSURE OVERLOAD LV HYPERTROPHY MYOCARDIAL ISCHEMIA CVA DUCTAL DEPENDENT LESIONS 4

5 DUCTAL DEPENDENT LESIONS Pulmonary Blood Flow Critical PS/ PAtresia TOF with PS or PAtresia SV with PS or Patresia Tricuspid Atresia Ebstein s Anomaly TRICUSPID ATRESIA Ebstein s Anomaly Ebstein s Anomaly Preoperative Pathophysiology Severe TR Functional and PS/PAt RV/LV Interaction Pulmonary Hypoplasia Anatomic HETEROTAXY SYNDROME Heterotaxy HETEROTAXY SYNDROME Asplenia Heterotaxy DORV/ CAVC TAPVR SubPS or PAtresia AET 5

6 HETEROTAXY SYNDROME Heterotaxy Polysplenia Primum ASD/ LVOTO Interrupted IVC Ipsilateral SVC/PVs CHB DUCTAL DEPENDENT LESIONS SYSTEMIC BLOOD FLOW CRITICAL AORTIC STENOSIS COARCTATION OF THE AORTA INTERRUPTED AORTIC ARCH HYPOPLASTIC LEFT HEART SYNDROME HYPOPLASTIC LEFT HEART SYNDROME SINGLE VENTRICLE PHYSIOLOGY INCREASED QP:QS RV VOLUME OVERLOAD EXTRACARDIAC ISSUES HYPOPLASTIC LEFT HEART SYNDROME SINGLE VENTRICLE PHYSIOLOGY INCREASED QP:QS RV VOLUME OVERLOAD EXTRACARDIAC ISSUES SINGLE VENTRICLE PHYSIOLOGY CRITERIA SYSTEMIC AND PULMONARY VENOUS RETURN TO COMMON MIXING CHAMBER SYSTEMIC AND PULMONARY BLOOD FLOW DETERMINED BY SYSTEMIC AND PULMONARY VASCULAR RESISTANCE Single Ventricle Physiology Qp:QS Calculation IF AO-MV OXYGEN% IS 25% IF PV OXYGEN% IS 95% THEN QP:QS = AO MV/ PV PA = 25 / 95 PA AND SINCE AO = PA SAT 25 / 95 POX 6

7 Single Ventricle Physiology Qp:QS (Pox 87%) IF AO-MV OXYGEN% IS 25% IF PV OXYGEN% IS 95% THEN QP:QS = AO MV/ PV PA = 25 / 95 PA AND SINCE AO = PA SAT 25 / = 3:1 HYPOPLASTIC LEFT HEART SYNDROME RV DYSFUNCTION (RV-LV) SINGLE VENTRICLE PHYSIOLOGY TRICUSPID REGURGITATION SHUNT STENOSIS/OBSTRUCTION RESIDUAL ARCH OBSTRUCTION RESTRICTIVE ASD NORWOOD HYPOPLASTIC LEFT HEART SYNDROME RV DYSFUNCTION (RV-LV) SINGLE VENTRICLE PHYSIOLOGY TRICUSPID REGURGITATION RVOT STENOSIS/OBSTRUCTION RESIDUAL ARCH OBSTRUCTION SANO Bidirectional Cavopulmonary Anastomosis Normal Profile PA PRESSURE MMHG LA PRESSURE 0-5 MMHG TP < 10 MMHG SATURATION 80 5% FONTAN MISCELLANEOUS 7

8 TRANSPOSITION OF THE GREAT ARTERIES MIXING ASD (MOST EFFECTIVE) VSD PDA COEXISTING PPHN (REVERSE DIFFERENTIAL CYANOSIS) TRANSPOSITION OF THE GREAT ARTERIES TRANSPOSITION OF THE GREAT ARTERIES PA saturation > Aortic saturation During systole (compliance of atria), atrial shunt is mostly L R During diastole (compliance of ventricles), mostly R L atrial shunt is TRANSPOSITION OF THE GREAT ARTERIES LV PREPAREDNESS CORONARY ISCHEMIA TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION OBSTRUCTIVE TYPE LUNG PATHOLOGY NONOBSTRUCTIVE TYPE RV VOLUME OVERLOAD TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION PULMONARY PATHOLOGY NONCOMPLIANT LV ATRIAL ECTOPIC TACHYCARDIA PV CONFLUENCE NARROWING 8

9 TRUNCUS ARTERIOSUS PEROPERATIVE PATHOPHYSIOLOGY INCREASED PULMONARY BLOOD FLOW AND PRESSURE BIVENTRICULAR VOLUME OVERLOAD TRUNCAL STENOSIS/ INSUFFICIENCY EXTRACARDIAC ISSUES TRUNCUS ARTERIOSUS RV RESTRICTIVE DYSFUNCTION JUNCTIONAL ECTOPIC TACHYCARDIA TRUNCAL STENOSIS/ INSUFFIENCY RESIDUAL VSD THE PRESSURE-VOLUME LOOP CARDIAC OUTPUT MANIPULATION CARDIAC OUTPUT MANIPULATION CARDIAC OUTPUT MANIPULATION PRELOAD 9

10 CARDIAC OUTPUT MANIPULATION AFTERLOAD CARDIAC OUTPUT MANIPULATION CONTRACTILITY VALVE STENOSIS [AORTIC] During ventricular ejection, LV pressure exceeds aortic pressure. Stroke volume is decreased; stroke work can be about the same but potential energy is increased. VALVE STENOSIS [MITRAL] During ventricular filling (diastole), LA pressure exceeds LVEDP. Both stroke volume and stroke work are decreased and the potential energy is unchanged. VALVE INSUFFICIENCY [AORTIC] During ventricular relaxation, blood flows backwards from aorta into to the LV. Pulse pressure widens. Both stroke volume and stroke work are increased but potential energy can be about the same. VALVE INSUFFICIENCY [MITRAL] During systole, LV ejects blood back into the LA as well as into the aorta. The LAP and the v-wave are increased. Both stroke volume and stroke work are increased but potential energy can be about the same. 10

11 VALVE INSUFFICIENCY [MITRAL] Acute- increased LA pressure with pulmonary edema and decreased cardiac output Chronic-increased LA size with little if any pulmonary edema and normal cardiac output Cardiac Cycle of Work/ Career Systole Diastole 11

Common types of congenital heart defects

Common types of congenital heart defects Common types of congenital heart defects Congenital heart defects are abnormalities that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only

More information

Anesthesia in Children with Congenital Heart Disease. Elliot Krane, M.D.

Anesthesia in Children with Congenital Heart Disease. Elliot Krane, M.D. Anesthesia in Children with Congenital Heart Disease Elliot Krane, M.D. Introduction The evolution of medicine to managed care and contracted medical services has often had the effect of shifting a sicker

More information

Resuscitation in congenital heart disease. Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto

Resuscitation in congenital heart disease. Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto Resuscitation in congenital heart disease Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto Evolution of Congenital Heart Disease Extraordinary success: Overall

More information

How to get insurance companies to work with you

How to get insurance companies to work with you Paying for Quality ACHD Care How to get insurance companies to work with you Christy Sillman, RN, MSN ACHD nurse coordinator Inpatient ACHD Nurse Educator The Adult Congenital Heart Program Stanford Lucile

More information

Cardiovascular Pathophysiology:

Cardiovascular Pathophysiology: Cardiovascular Pathophysiology: Right to Left Shunts aka Cyanotic Lesions Ismee A. Williams, MD, MS iib6@columbia.edu Pediatric Cardiology What is Cyanosis? Bluish discoloration of skin that occurs when

More information

Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray

Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray Ra-id Abdulla and Douglas M. Luxenberg Key Facts The cardiac silhouette occupies 50 55% of the chest width on an anterior posterior chest X-ray

More information

Congenital Heart Defects Initial Diagnosis and

Congenital Heart Defects Initial Diagnosis and Congenital Heart Defects Initial Diagnosis and Management age e Linda Risley, RN, MSN, CPNP Congenital Heart Defects Congenital heart defects are the most common type of birth defect ~1 out of 100 live

More information

Congenital Heart Defects

Congenital Heart Defects Congenital Heart Defects 1 Congenital Heart Defects CHD with Increased Pulmonary Blood Flow Patent Ductus Arteriosus - PDA...3 Atrial Septal Defect - ASD...4 Ventricular Septal Defect - VSD...5 Aorto-Pulmonary

More information

Questions FOETAL CIRCULATION ANAESTHESIA TUTORIAL OF THE WEEK 91 18 TH MAY 2008

Questions FOETAL CIRCULATION ANAESTHESIA TUTORIAL OF THE WEEK 91 18 TH MAY 2008 FOETAL CIRCULATION ANAESTHESIA TUTORIAL OF THE WEEK 91 18 TH MAY 2008 Dr. S. Mathieu, Specialist Registrar in Anaesthesia Dr. D. J. Dalgleish, Consultant Anaesthetist Royal Bournemouth and Christchurch

More information

Left And Right Heart Cath. Mohd Shafullah Serdari RDCS, RCS, RCIS Institut Jantung Negara

Left And Right Heart Cath. Mohd Shafullah Serdari RDCS, RCS, RCIS Institut Jantung Negara Left And Right Heart Cath Mohd Shafullah Serdari RDCS, RCS, RCIS Institut Jantung Negara Overview Right and left heart cath is a procedure where a catheter is inserted into the cardiac chambers and vessels

More information

Left to Right Shunts and their Calculation. Ghada El Shahed, MD

Left to Right Shunts and their Calculation. Ghada El Shahed, MD Left to Right Shunts and their Calculation Ghada El Shahed, MD Professor of Cardiology Ain Shams University Flow through systemic & pulmonary circulations is normally balanced and equal. Two circulations

More information

020 // Congenital Heart Disease

020 // Congenital Heart Disease 020 // Congenital Heart Disease CONTENTS 188 Basics 188 Atrial Septal Defect (ASD) 191 Patent Foramen Ovale (PFO) 192 Ventricular Septal Defects (VSD) 194 Patent Ductus Arteriosus (PDA) 195 Coronary Fistulas

More information

Current status of pediatric cardiac surgery

Current status of pediatric cardiac surgery Current status of pediatric cardiac surgery Sabine H. Daebritz Dept. of Cardio-vascular Surgery Heart Center Duisburg, Germany Normal circulation 1 Complex cardiac lesions Stenoses Shunts Malconnections

More information

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Optimizes detection of congenital heart disease (chd) in the general low risk obstetrical population Daniel J. Cohen, M.D. danjcohen@optonline.net

More information

Cardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page

Cardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page Cardiology Fellowship Manual Goals & Objectives -Cardiac Imaging- 1 Page 2015-2016 UNIV. OF NEBRASKA CHILDREN S HOSPITAL & MEDICAL CENTER DIVISION OF CARDIOLOGY FELLOWSHIP PROGRAM CARDIAC IMAGING ROTATION

More information

Note: The left and right sides of the heart must pump exactly the same volume of blood when averaged over a period of time

Note: The left and right sides of the heart must pump exactly the same volume of blood when averaged over a period of time page 1 HEART AS A PUMP A. Functional Anatomy of the Heart 1. Two pumps, arranged in series a. right heart: receives blood from the systemic circulation (via the great veins and vena cava) and pumps blood

More information

Question 1: Interpret the rhythm strip above (comment on regularity, rate, P wave, PR interval and QRS)?

Question 1: Interpret the rhythm strip above (comment on regularity, rate, P wave, PR interval and QRS)? It is your first month on your NICU rotation and you are prerounding on your patients. The nurse takes you aside and says she s been seeing something funny on the cardiac monitor. You walk to the bedside

More information

Pulmonary Atresia With Intact Ventricular Septum - Anatomy, Physiology, and Diagnostic Imaging

Pulmonary Atresia With Intact Ventricular Septum - Anatomy, Physiology, and Diagnostic Imaging Pulmonary Atresia With Intact Ventricular Septum - Anatomy, Physiology, and Diagnostic Imaging Larry Latson MD Director of Pediatric Interventional Cardiology and Adult CHD Joe DiMaggio Children s Hospital

More information

Atrial Septal Defect. Non-cyanotic defects. Ventricular Septal Defect 10/8/2009. Hot Topics in Pediatric Cardiology. Treatment in Cath Lab

Atrial Septal Defect. Non-cyanotic defects. Ventricular Septal Defect 10/8/2009. Hot Topics in Pediatric Cardiology. Treatment in Cath Lab Hot Topics in Pediatric Cardiology Review of Major Defects Fetal Diagnosis of Congenital Heart Disease Neonatal Diagnosis of CHD Treatment in Cath Lab Heart Surgery Outcomes Primary Care Issues after Heart

More information

Delivery Planning for the Fetus with Congenital Heart Disease

Delivery Planning for the Fetus with Congenital Heart Disease Delivery Planning for the Fetus with Congenital Heart Disease Mar y T. Donofrio MD, FAAP, FACC, FASE Director of the Fetal Heart Program Children s National Medical Center Washington DC Objectives Review

More information

The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb.

The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb. The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb. 7-8, 2013 Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology

More information

Normal Intracardiac Pressures. Lancashire & South Cumbria Cardiac Network

Normal Intracardiac Pressures. Lancashire & South Cumbria Cardiac Network Normal Intracardiac Pressures Lancashire & South Cumbria Cardiac Network Principle Pressures recorded from catheter tip Electrical transducer - wheatstone bridge mechanical to electrical waveform display

More information

ACYANOTIC HEART DEFECTS

ACYANOTIC HEART DEFECTS ACYANOTIC HEART DEFECTS Acyanotic congenital heart defects may be due to obstructive lesions (stenosis) or left-to-right shunts. Lesions with left-to-right shunts include atrial septal defect, ventricular

More information

Section Four: Pulmonary Artery Waveform Interpretation

Section Four: Pulmonary Artery Waveform Interpretation Section Four: Pulmonary Artery Waveform Interpretation All hemodynamic pressures and waveforms are generated by pressure changes in the heart caused by myocardial contraction (systole) and relaxation/filling

More information

25 Anomalies and Diseases of the Fetal Heart

25 Anomalies and Diseases of the Fetal Heart 270 25 Anomalies and Diseases of the Fetal Heart Epidemiology and Indications for Fetal Echocardiography Epidemiologic Aspects It is generally known that approximately 15 20% of pregnancies in the second

More information

Normal & Abnormal Intracardiac. Lancashire & South Cumbria Cardiac Network

Normal & Abnormal Intracardiac. Lancashire & South Cumbria Cardiac Network Normal & Abnormal Intracardiac Pressures Lancashire & South Cumbria Cardiac Network Principle Pressures recorded from catheter tip Electrical transducer - wheatstone bridge mechanical to electrical waveform

More information

COACH Columbus Ohio Adult Congenital Heart Disease Program The Heart Center at Nationwide Children s Hospital & The Ohio State University

COACH Columbus Ohio Adult Congenital Heart Disease Program The Heart Center at Nationwide Children s Hospital & The Ohio State University COACH Columbus Ohio Adult Congenital Heart Disease Program The Heart Center at Nationwide Children s Hospital & The Ohio State University Single Ventricle Defects Normal Heart Structure The heart normally

More information

Disclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease

Disclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease March of Dimes New York State Chapter 36th Annual Perinatal Nurses Conference Promoting Perinatal Health Through Evidence Based Practice Not As Pink As You Think: Pulse Oximetry Screening For Critical

More information

ANESTHESIA FOR PATIENTS POST CHD REPAIR

ANESTHESIA FOR PATIENTS POST CHD REPAIR ANESTHESIA FOR PATIENTS POST CHD REPAIR ABDULLAH HALAWANI, MBBS, FRCPC. Consultant CVT Anesthesiologist Head, Section of Pediatric Anesthesia KFSH & RC, Riyadh 1 Congenital Heart Disease (CHD) is one of

More information

Chapter 9. The Cardiovascular System

Chapter 9. The Cardiovascular System Chapter 9 The Cardiovascular System Objectives Describe the anatomy of the heart and vascular systems. State the key characteristics of cardiac tissue. Calculate systemic vascular resistance given mean

More information

Chromosome Syndromes associated with Congenital Heart Defects

Chromosome Syndromes associated with Congenital Heart Defects National Birth Defects Prevention Network (NBPDN)/NBDPS Annual Meeting Feb. 26-29. 2012 Arlington, VA Chromosome Syndromes associated with Congenital Heart Defects Angela E. Lin, MD, FAAP, FACMG Associate

More information

Cardiac Catheterization in Patients with Pulmonary Hypertension

Cardiac Catheterization in Patients with Pulmonary Hypertension Cardiac Catheterization in Patients with Pulmonary Hypertension Russel Hirsch, M.D. And James Tarver, M.D. Cincinnati Chldren s Hospital Medical Center And Orlando Heart Center Disclosures Russel Hirsch

More information

Nutrition in Paediatric Cardiology. Karen Hayes Paediatric Dietitian Addenbrooke s Hospital

Nutrition in Paediatric Cardiology. Karen Hayes Paediatric Dietitian Addenbrooke s Hospital Nutrition in Paediatric Cardiology Karen Hayes Paediatric Dietitian Addenbrooke s Hospital Topics Who needs Nutrition support? Energy Requirements Meeting Energy and growth requirements Feeding Issues

More information

Fellow TEE Review Workshop Hemodynamic Calculations 2013. Director, Intraoperative TEE Program. Johns Hopkins School of Medicine

Fellow TEE Review Workshop Hemodynamic Calculations 2013. Director, Intraoperative TEE Program. Johns Hopkins School of Medicine Fellow TEE Review Workshop Hemodynamic Calculations 2013 Mary Beth Brady, MD, FASE Director, Intraoperative TEE Program Johns Hopkins School of Medicine At the conclusion of the workshop, the participants

More information

Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery

Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery Srinivasan Rajagopal M.D. Assistant Professor Division of Cardiothoracic Anesthesia Objectives Describe the pathophysiology

More information

Congenital heart defects

Congenital heart defects CONGENITAL ANOMALY REGISTER & INFORMATION SERVICE COFRESTR ANOMALEDDAU CYNHENID Congenital heart defects Cardiovascular defects are by far the commonest major group of congenital anomalies. Development

More information

CTA OF THE EXTRACORONARY HEART

CTA OF THE EXTRACORONARY HEART CTA OF THE EXTRACORONARY HEART Charles White MD Director of Thoracic Imaging Department of Radiology University of Maryland NO DISCLOSURES CWHITE@UMM.EDU CARDIAC CASE DISTRIBUTION Coronary CTA 30% ED chest

More information

Heart Pump and Cardiac Cycle. Faisal I. Mohammed, MD, PhD

Heart Pump and Cardiac Cycle. Faisal I. Mohammed, MD, PhD Heart Pump and Cardiac Cycle Faisal I. Mohammed, MD, PhD 1 Objectives To understand the volume, mechanical, pressure and electrical changes during the cardiac cycle To understand the inter-relationship

More information

Presentation of Congenital Heart Disease in the Neonate and Young Infant

Presentation of Congenital Heart Disease in the Neonate and Young Infant Presentation of Congenital Heart Disease in the Neonate and Young Infant Article cardiology Michael Silberbach, MD,* David Hannon, MD Author Disclosure Drs Silberbach and Hannon did not disclose any financial

More information

1p36 and the Heart. John Lynn Jefferies, MD, MPH, FACC, FAHA

1p36 and the Heart. John Lynn Jefferies, MD, MPH, FACC, FAHA 1p36 and the Heart John Lynn Jefferies, MD, MPH, FACC, FAHA Director, Advanced Heart Failure and Cardiomyopathy Services Associate Professor, Pediatric Cardiology and Adult Cardiovascular Diseases Associate

More information

Extrauterine Transition Umbilical cord clamped and respirations initiated, increased PaO2 levels cause:

Extrauterine Transition Umbilical cord clamped and respirations initiated, increased PaO2 levels cause: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 PEDIATRIC CARDIOLOGY Nursing 210 Extrauterine Transition Umbilical cord clamped and respirations initiated, increased PaO2 levels cause: Cardiac Defects 8% of newborn are

More information

HEART MURMURS THROUGHOUT CHILDHOOD

HEART MURMURS THROUGHOUT CHILDHOOD HEART MURMURS THROUGHOUT CHILDHOOD Frances R. Zappalla, D.O. Nemours Cardiac Center A.I. du Pont Hospital for Children Wilmington, DE Definition: HEART MURMURS An extra abnormal heart sound usually detected

More information

The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography

The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography Bahrain Medical Bulletin, Vol. 36, No. 2, June 2014 ABSTRACT The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography Hussain Al Khawahur, MD* Hussain Al Sowaiket, MD** Thuria

More information

Heart Disorders Glossary

Heart Disorders Glossary Heart Disorders Glossary ABG (Arterial Blood Gas) Test: A test that measures how much oxygen and carbon dioxide are in the blood. Anemia: A condition in which there are low levels of red blood cells in

More information

Heart Failure EXERCISES. Ⅰ. True or false questions (mark for true question, mark for false question. If it is false, correct it.

Heart Failure EXERCISES. Ⅰ. True or false questions (mark for true question, mark for false question. If it is false, correct it. Heart Failure EXERCISES Ⅰ. True or false questions (mark for true question, mark for false question. If it is false, correct it. ) 1. Heart rate increase is a kind of economic compensation, which should

More information

CURRICULUM VITAE MUTHU JOTHI

CURRICULUM VITAE MUTHU JOTHI CURRICULUM VITAE MUTHU JOTHI Nationality: Indian Date of Birth: 2 st April 965 Residential Address: A-32 Mayflower Shakthi Gardens Nanjundapuram Road, Coimbatore Pin :64036 Phone: 0(9)422-2325532 Mobile

More information

Confirmed CCHD What next?

Confirmed CCHD What next? Confirmed CCHD What next? Herbert J. Stern MD, FACC, FSCAI Children s Cardiology Associates and Dell Children s Hospital Catheter Based Therapy: Spectrum of Procedures Tear PFO to enhance mixing (D-TGA)

More information

Congenital Heart Disease. Mary Rummell, RN, MN, CPNP, CNS Clinical Nurse Specialist Pediatric Cardiology/Cardiac Surgery

Congenital Heart Disease. Mary Rummell, RN, MN, CPNP, CNS Clinical Nurse Specialist Pediatric Cardiology/Cardiac Surgery Congenital Heart Disease Mary Rummell, RN, MN, CPNP, CNS Clinical Nurse Specialist Pediatric Cardiology/Cardiac Surgery Objectives The learner will: Identify 3 areas in the developing heart that result

More information

Anaesthesia and Heart Failure

Anaesthesia and Heart Failure Anaesthesia and Heart Failure Andrew Baldock, Specialist Registrar, Southampton University Hospitals NHS Trust E mail: ajbaldock@doctors.org.uk Self-assessment The following true/false questions may be

More information

Heart Sounds & Murmurs

Heart Sounds & Murmurs Cardiovascular Physiology Heart Sounds & Murmurs Dr. Abeer A. Al-Masri MBBS, MSc, PhD Associate Professor Consultant Cardiovascular Physiologist Faculty of Medicine, KSU Detected over anterior chest wall

More information

The Cardiac Cycle. Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.

The Cardiac Cycle. Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc. The Cardiac Cycle Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1. Introduction The cardiac cycle includes all the events related

More information

Objectives. The ECG in Pulmonary and Congenital Heart Disease. Lead II P-Wave Amplitude during COPD Exacerbation and after Treatment (50 pts.

Objectives. The ECG in Pulmonary and Congenital Heart Disease. Lead II P-Wave Amplitude during COPD Exacerbation and after Treatment (50 pts. The ECG in Pulmonary and Congenital Heart Disease Gabriel Gregoratos, MD Objectives Review the pathophysiology and ECG signs of pulmonary dysfunction Review the ECG findings in patients with: COPD (chronic

More information

Doc, I Am Fine, But I Have A Cardiac Condition

Doc, I Am Fine, But I Have A Cardiac Condition Doc, I Am Fine, But I Have A Cardiac Condition Nevine Mahmoud, MD John Ludtke, MD Maj, USAFR, MC, FS RAM Class 2014 Wright State University Boonshoft School of Medicine Division of Aerospace Medicine Dayton,

More information

Congenital Diaphragmatic Hernia By Dr. N. Robert Payne

Congenital Diaphragmatic Hernia By Dr. N. Robert Payne The following material was developed prior to RGA s acquisition on January 1, 2010 of the Group Reinsurance Business formerly formerly owned owned by ReliaStar by Life ReliaStar Insurance Life Company

More information

Mr GH: Pericardial Window. Anaesthetic Management of Cardiac Tamponade

Mr GH: Pericardial Window. Anaesthetic Management of Cardiac Tamponade Mr GH: Pericardial Window Anaesthetic Management of Cardiac Tamponade Mr GH 56 yo M HOPCx Asbestosis, adenoca R lung 8/52 6/52 cisplatin/ taxol chemo Weekly pleural taps for effusions Sent from Bendigo

More information

What is echo? CHAPTER 1 1.1 BASIC NOTIONS. Ultrasound production and detection

What is echo? CHAPTER 1 1.1 BASIC NOTIONS. Ultrasound production and detection What is echo? CHAPTER 1 1.1 BASIC NOTIONS Echocardiography (echo) the use of ultrasound to examine the heart is a safe, powerful, non-invasive and painless technique. Echo is easy to understand as many

More information

Cardiac Disorders of the Newborn

Cardiac Disorders of the Newborn Cardiac Disorders of the Newborn Lance A. Parton, MD, FAAP Associate Director Regional NICU Maria Fareri Children s Hospital at Westchester Medical Center Professor of Pediatrics OB/Gyn, Anesthesiology

More information

1 Congestive Heart Failure & its Pharmacological Management

1 Congestive Heart Failure & its Pharmacological Management Harvard-MIT Division of Health Sciences and Technology HST.151: Principles of Pharmocology Instructor: Prof. Keith Baker 1 Congestive Heart Failure & its Pharmacological Management Keith Baker, M.D., Ph.D.

More information

Pediatric Congenital Cardiac Surgery

Pediatric Congenital Cardiac Surgery Pediatric Congenital Cardiac Surgery in New York State 2006 2009 New York State Department of Health October 2011 Members of the New York State Cardiac Advisory Committee Chair Spencer King, M.D. Executive

More information

Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9, 2010

Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9, 2010 Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9, 2010 Ileana Piña, MD, MPH American Heart Association/American

More information

Definitions. Child LifeAdvance. Critical Illness Insurance Plan

Definitions. Child LifeAdvance. Critical Illness Insurance Plan Definitions Child LifeAdvance Critical Illness Insurance Plan Child LifeAdvance This is specimen wording only and is not binding. In the event of any inconsistency between the information contained in

More information

Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn

Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn A presentation of Texas Pulse Oximetry Project: A Joint Educational Initiative of The University of Texas Health Science

More information

Auscultation of the Heart

Auscultation of the Heart Review of Clinical Signs uscultation of the Heart Series Editor: Bernard Karnath, MD Bernard Karnath, MD William Thornton, MD uscultation of the heart can provide clues to the diagnosis of many cardiac

More information

Prenatal Diagnosis of Congenital Heart Disease

Prenatal Diagnosis of Congenital Heart Disease Prenatal Diagnosis of Congenital Heart Disease Pei-NiJone, MD a, Kenneth O. Schowengerdt, Jr., MD b, * KEYWORDS Fetal echocardiography Prenatal diagnosis Neonatal heart disease Fetal echocardiography,

More information

HEART DISEASE IN THE YOUNG CHARLES S. KLEINMAN, M.D.

HEART DISEASE IN THE YOUNG CHARLES S. KLEINMAN, M.D. CHAPTER 20 HEART DISEASE IN THE YOUNG CHARLES S. KLEINMAN, M.D. INTRODUCTION Congenital heart defects are relatively rare; seriously debilitating heart abnormalities rarer still. Approximately 8 babies

More information

Facts about Congenital Heart Defects

Facts about Congenital Heart Defects Facts about Congenital Heart Defects Joseph A. Sweatlock, Ph.D., DABT New Jersey Department of Health Early Identification & Monitoring Program Congenital heart defects are conditions that are present

More information

Introduction to CV Pathophysiology. Introduction to Cardiovascular Pathophysiology

Introduction to CV Pathophysiology. Introduction to Cardiovascular Pathophysiology Introduction to CV Pathophysiology Munther K. Homoud, MD Tufts-New England Medical Center Spring 2008 Introduction to Cardiovascular Pathophysiology 1. Basic Anatomy 2. Excitation Contraction Coupling

More information

Dynamic Auscultation of Heart Sounds and Murmurs. Acknowledgement. Disclosures Real or Potential Conflicts of Interest

Dynamic Auscultation of Heart Sounds and Murmurs. Acknowledgement. Disclosures Real or Potential Conflicts of Interest Dynamic Auscultation of Heart Sounds and Murmurs W. Lane Edwards, Jr., MSN, ARNP, ANP Hospitalist Group of Southwest Florida Affiliate Professor of Nursing, University of Alaska at Anchorage Acknowledgement

More information

Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD

Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD Dalhousie Fall Refresher Course 2015 Kenny K Wong, MD, FRCPC Pediatric Cardiologist Associate Professor of Pediatrics Objectives

More information

THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS

THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS MEDICAL CENTER ARCHIVES OF NEWYORK-PRESBYTERIAN/WEILL CORNELL 1300 York Avenue # 34 New York, NY 10065 Finding Aid To THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS Dates of Papers: 1948-1991 52.5 Linear

More information

Practical class 3 THE HEART

Practical class 3 THE HEART Practical class 3 THE HEART OBJECTIVES By the time you have completed this assignment and any necessary further reading or study you should be able to:- 1. Describe the fibrous pericardium and serous pericardium,

More information

Adult Congenital Heart Disease and Pulmonary Arterial Hypertension. Patient Information

Adult Congenital Heart Disease and Pulmonary Arterial Hypertension. Patient Information Adult Congenital Heart Disease and Pulmonary Arterial Hypertension Patient Information WHAT IS CONGENITAL HEART DISEASE? Congenital heart disease (CHD) refers to a defect of the heart or major blood vessels

More information

Additional information and program contacts on population-based birth defects surveillance programs are available on page S122.

Additional information and program contacts on population-based birth defects surveillance programs are available on page S122. STATE BIRTH DEFECTS SURVEILLANCE PROGRAM DATA S Major Birth Defects Data from Population-based Birth Defects Surveillance Programs in the United States, - Updated August Prepared by the National Center

More information

HEART HEALTH WEEK 3 SUPPLEMENT. A Beginner s Guide to Cardiovascular Disease HEART FAILURE. Relatively mild, symptoms with intense exercise

HEART HEALTH WEEK 3 SUPPLEMENT. A Beginner s Guide to Cardiovascular Disease HEART FAILURE. Relatively mild, symptoms with intense exercise WEEK 3 SUPPLEMENT HEART HEALTH A Beginner s Guide to Cardiovascular Disease HEART FAILURE Heart failure can be defined as the failing (insufficiency) of the heart as a mechanical pump due to either acute

More information

Sao Paulo Brazil UNIDADE FETAL

Sao Paulo Brazil UNIDADE FETAL Simone R. F. Fontes Pedra, MD Si R F F P d MD Sao Paulo Brazil UNIDADE FETAL FROM CONCEPTION TO MATURITY: BUILDING A FETAL THERAPY PROGRAM Simone R F Fontes Simone R. F. Fontes Simone R. F. FontesPedra

More information

RACE I Rapid Assessment by Cardiac Echo. Intensive Care Training Program Radboud University Medical Centre NIjmegen

RACE I Rapid Assessment by Cardiac Echo. Intensive Care Training Program Radboud University Medical Centre NIjmegen RACE I Rapid Assessment by Cardiac Echo Intensive Care Training Program Radboud University Medical Centre NIjmegen RACE Goal-directed study with specific questions Excludes Doppler ultrasound Perform 50

More information

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Feeding in Infants with Complex Congenital Heart Disease Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Objectives Discuss common feeding issues in patients with

More information

Review of the Cardiac Unit at the Royal Liverpool Children s Hospital NHS Trust Alder Hey

Review of the Cardiac Unit at the Royal Liverpool Children s Hospital NHS Trust Alder Hey I N F O R M A T I O N Review of the Cardiac Unit at the Royal Liverpool Children s Hospital NHS Trust Alder Hey by Professor John R. Ashton CBE Regional Director of Public Health, National Health Service,

More information

Therapeutic Cardiac Catheterizations for Children with Congenital Heart Disease

Therapeutic Cardiac Catheterizations for Children with Congenital Heart Disease Therapeutic Cardiac Catheterizations for Children with Congenital Heart Disease Introduction A therapeutic cardiac catheterization is a procedure performed to treat your child s heart defect. A doctor

More information

Consider the following 2 cases and discuss the questions below before reading the tutorial.

Consider the following 2 cases and discuss the questions below before reading the tutorial. Recognising Cardiac Disease in Children Name: Hospital: E-mail: Elizabeth Storey Leeds Teaching Hospitals, UK kate@medex.org.uk Consider the following 2 cases and discuss the questions below before reading

More information

Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities

Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities Original article Arch Argent Pediatr 2013;111(5):418-422 / 418 Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities

More information

Cardiovascular Pathophysiology: Left To Right Shunts Ismee A. Williams, MD, MS

Cardiovascular Pathophysiology: Left To Right Shunts Ismee A. Williams, MD, MS Cardiovascular Pathophysiology: Left To Right Shunts Ismee A. Williams, MD, MS iib6@columbia.edu Learning Objectives Learn the relationships between pressure, blood flow, and resistance Review the transition

More information

Dental Work and the Risk of Bacterial Endocarditis

Dental Work and the Risk of Bacterial Endocarditis Variety Children s Heart Centre Dental Work and the Risk of Bacterial Endocarditis Certain heart conditions and structural defects increase the risk of developing endocarditis (a heart valve infection)

More information

Diagnostic and Therapeutic Procedures

Diagnostic and Therapeutic Procedures Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,

More information

CARDIAC DISORDERS. Circulatory Changes at Birth 7/3/2008

CARDIAC DISORDERS. Circulatory Changes at Birth 7/3/2008 CARDIAC DISORDERS Circulatory Changes at Birth When the umbilical cord is clamped, the blood supply from the placenta is cut off, and oxygenation must then take place in the infant s lungs As the lungs

More information

Anatomi & Fysiologi 060301. The cardiovascular system (chapter 20) The circulation system transports; What the heart can do;

Anatomi & Fysiologi 060301. The cardiovascular system (chapter 20) The circulation system transports; What the heart can do; The cardiovascular system consists of; The cardiovascular system (chapter 20) Principles of Anatomy & Physiology 2009 Blood 2 separate pumps (heart) Many blood vessels with varying diameter and elasticity

More information

The Newborn With a Congenital Disorder. Chapter 14. Copyright 2008 Wolters Kluwer Health Lippincott Williams & Wilkins

The Newborn With a Congenital Disorder. Chapter 14. Copyright 2008 Wolters Kluwer Health Lippincott Williams & Wilkins The Newborn With a Congenital Disorder Chapter 14 Congenital Anomalies or Malformations May be caused by genetic or environmental factors Approximately 2% to 3% of all infants born have a major malformation

More information

Heart and Vascular System Practice Questions

Heart and Vascular System Practice Questions Heart and Vascular System Practice Questions Student: 1. The pulmonary veins are unusual as veins because they are transporting. A. oxygenated blood B. de-oxygenated blood C. high fat blood D. nutrient-rich

More information

Anatomy Review. Heart Murmurs. Surface Topography of the Heart 7/19/2011. The Base of the Heart and Erb s Point

Anatomy Review. Heart Murmurs. Surface Topography of the Heart 7/19/2011. The Base of the Heart and Erb s Point James A Mathey PA C, MPA CAPA WORKSHOP 2010 Heart Murmurs Anatomy Review 4 Classic Auscultatory Areas: Aortic 2ICS R SB Pulmonic 2ICS L SB Tricuspid 4 th L Lower SB Mitral 5ICS MCL Surface Topography of

More information

North Dakota Birth Defects Monitoring System

North Dakota Birth Defects Monitoring System North Dakota Birth Defects Monitoring System Summary Report 1995-1999 North Dakota Department of Health North Dakota Birth Defects Monitoring System Summary Report 1995 1999 John Hoeven, Governor Dr. Terry

More information

Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program

Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program WHAT S KNOWN ON THIS SUBJECT: Prenatal diagnosis and clinical examination do not identify all infants with critical

More information

Nursing 210 Advanced Cardiac UNIT 2 2.3, 2.4, 2.5. Laurie Brown RN, MSN, MPA-HA, CCRN

Nursing 210 Advanced Cardiac UNIT 2 2.3, 2.4, 2.5. Laurie Brown RN, MSN, MPA-HA, CCRN Nursing 210 Advanced Cardiac UNIT 2 2.3, 2.4, 2.5 Laurie Brown RN, MSN, MPA-HA, CCRN Vascular Disorders Arterial or Venous Ischemia or Excessive accumulation of waste and fluid Prevention The First Treatment

More information

Chapter 20: The Cardiovascular System: The Heart

Chapter 20: The Cardiovascular System: The Heart Chapter 20: The Cardiovascular System: The Heart Chapter Objectives ANATOMY OF THE HEART 1. Describe the location and orientation of the heart within the thorax and mediastinal cavity. 2. Describe the

More information

Exchange solutes and water with cells of the body

Exchange solutes and water with cells of the body Chapter 8 Heart and Blood Vessels Three Types of Blood Vessels Transport Blood Arteries Carry blood away from the heart Transport blood under high pressure Capillaries Exchange solutes and water with cells

More information

Hello. I would like to think everyone for coming this morning. I m going to talk about heart disease in pregnancy.

Hello. I would like to think everyone for coming this morning. I m going to talk about heart disease in pregnancy. Hello. I would like to think everyone for coming this morning. I m going to talk about heart disease in pregnancy. 1 I have a few objectives for this talk. First, we ll review the normal, anticipated chambers

More information

Sign up to receive ATOTW weekly - email worldanaesthesia@mac.com

Sign up to receive ATOTW weekly - email worldanaesthesia@mac.com TETRALOGY OF FALLOT ANAESTHESIA TUTORIAL OF THE WEEK 219 18 TH APRIL 2011 Dr Lucy Hepburn Great Ormond Street Hospital NHS Trust Correspondence to: HepbuL@gosh.nhs.uk QUESTIONS Before continuing, try to

More information

THE HEART Dr. Ali Ebneshahidi

THE HEART Dr. Ali Ebneshahidi THE HEART Dr. Ali Ebneshahidi Functions is of the heart & blood vessels 1. The heart is an essential pumping organ in the cardiovascular system where the right heart pumps deoxygenated blood (returned

More information

Distance Learning Program Anatomy of the Human Heart/Pig Heart Dissection Middle School/ High School

Distance Learning Program Anatomy of the Human Heart/Pig Heart Dissection Middle School/ High School Distance Learning Program Anatomy of the Human Heart/Pig Heart Dissection Middle School/ High School This guide is for middle and high school students participating in AIMS Anatomy of the Human Heart and

More information

5. Management of rheumatic heart disease

5. Management of rheumatic heart disease 5. Management of rheumatic heart disease The fundamental goal in the long-term management of RHD is to prevent ARF recurrences, and therefore, prevent the progression of RHD, and in many cases allow for

More information

Diagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses

Diagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses Diagnosis Code Crosswalk : to 402.01 Hypertensive heart disease, malignant, with heart failure 402.11 Hypertensive heart disease, benign, with heart failure 402.91 Hypertensive heart disease, unspecified,

More information