Cardiac Knowledge Check
1.Normal Blood Flow Pathway:
1. Deoxygenated blood enters right atrium via superior/inferior vena cava
2. Through tricuspid valve into right ventricle
3. Through pulmonary valve into pulmonary artery to lungs
4. Oxygenated blood returns to left atrium via pulmonary veins
5. Through mitral valve into left ventricle
6. Through aortic valve into aorta → systemic circulation
2. Fetal Circulation Changes After Delivery
• Before birth: Blood bypasses the lungs via the ductus arteriosus and foramen ovale
• After delivery:
o Lungs expand → pulmonary vascular resistance ↓
o Increased left atrial pressure closes foramen ovale
o Ductus arteriosus constricts and becomes the ligamentum arteriosum
o Systemic and pulmonary circulations become separate.
3. Clinical Manifestations of Pediatric Cardiac Dysfunction
• Poor feeding
• Tachypnea, especially with exertion
• Diaphoresis
• Failure to thrive
• Frequent respiratory infections
• Murmurs
• Cyanosis
• Edema, especially periorbital or sacral in infants.
4. Definitions
, a. Cardiac Output (CO):
Amount of blood ejected by the heart per minute (CO = HR × SV).
b. Stroke Volume (SV):
Volume of blood ejected by the left ventricle with each contraction.
5. Types of Cardiac Defects
• Acyanotic Defects: ↑ pulmonary blood flow
o Atrial septal defect (ASD)
o Ventricular septal defect (VSD)
o Patent ductus arteriosus (PDA)
• Cyanotic Defects: ↓ pulmonary blood flow
o Tetralogy of Fallot
o Tricuspid atresia
• Obstructive Defects
o Coarctation of the aorta
o Aortic stenosis
o Pulmonary stenosis
• Mixed Defects
o Transposition of the great arteries
o Hypoplastic left heart syndrome
6. Congestive Heart Failure (CHF)
a. Clinical Manifestations:
• Tachypnea, dyspnea, poor feeding, FTT
• Hepatomegaly, peripheral edema, jugular vein distention (older child)
b. Diagnostics:
• Chest X-ray, ECG, echocardiogram, BNP levels
c. Medical Management:
• Medications: Digoxin, diuretics (furosemide), ACE inhibitors
1.Normal Blood Flow Pathway:
1. Deoxygenated blood enters right atrium via superior/inferior vena cava
2. Through tricuspid valve into right ventricle
3. Through pulmonary valve into pulmonary artery to lungs
4. Oxygenated blood returns to left atrium via pulmonary veins
5. Through mitral valve into left ventricle
6. Through aortic valve into aorta → systemic circulation
2. Fetal Circulation Changes After Delivery
• Before birth: Blood bypasses the lungs via the ductus arteriosus and foramen ovale
• After delivery:
o Lungs expand → pulmonary vascular resistance ↓
o Increased left atrial pressure closes foramen ovale
o Ductus arteriosus constricts and becomes the ligamentum arteriosum
o Systemic and pulmonary circulations become separate.
3. Clinical Manifestations of Pediatric Cardiac Dysfunction
• Poor feeding
• Tachypnea, especially with exertion
• Diaphoresis
• Failure to thrive
• Frequent respiratory infections
• Murmurs
• Cyanosis
• Edema, especially periorbital or sacral in infants.
4. Definitions
, a. Cardiac Output (CO):
Amount of blood ejected by the heart per minute (CO = HR × SV).
b. Stroke Volume (SV):
Volume of blood ejected by the left ventricle with each contraction.
5. Types of Cardiac Defects
• Acyanotic Defects: ↑ pulmonary blood flow
o Atrial septal defect (ASD)
o Ventricular septal defect (VSD)
o Patent ductus arteriosus (PDA)
• Cyanotic Defects: ↓ pulmonary blood flow
o Tetralogy of Fallot
o Tricuspid atresia
• Obstructive Defects
o Coarctation of the aorta
o Aortic stenosis
o Pulmonary stenosis
• Mixed Defects
o Transposition of the great arteries
o Hypoplastic left heart syndrome
6. Congestive Heart Failure (CHF)
a. Clinical Manifestations:
• Tachypnea, dyspnea, poor feeding, FTT
• Hepatomegaly, peripheral edema, jugular vein distention (older child)
b. Diagnostics:
• Chest X-ray, ECG, echocardiogram, BNP levels
c. Medical Management:
• Medications: Digoxin, diuretics (furosemide), ACE inhibitors