Peds H- Heart Failure and Congenital Heart Disorders
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 4 February 2018
⏱️ 8 minutes
🧾️ Download transcript
Summary
Common Chief Complaints
* Cyanosis* Difficulty feeding* Failure to thrive
Cyanotic Heart Lesions
* Truncus arteriosus* Aorta and pulmonary artery are fused* Single vessel comes from both ventricles* Transposition of great vessels* Aorta comes off RIGHT ventricle* Pulmonary artery comes off LEFT ventricle* Tricuspid atresia* Blood unable to get from right atrium to right ventricle* Tetrology of fallot* Overriding aorta* Ventricular septal defect* Right ventricular outflow tract obstruction* Hypertrophy of right ventricle* Total anomalous pulmonary venous return* Pulmonary vein empties into the right ventricle
Ductal Dependent Lesions
* Classically presents in first 30 days of life* Treatment = Prostaglandins* Common lesions* Hypoplastic left heart* Aortic stenosis* Coarctation of the aorta
Congestive Heart Failure
* Common Presentation* Difficulty feeding* Organomegaly* Cardiomegaly on CXR* Treatment* Furosemide* Vasopressors* Admit
Additional Reading
* Congenital Heart Disease Emergencies (EM Cases)* Ductal Dependent Congenital Heart Defects (CodeHealth)
Transcript
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| 0:00.0 | Hello, med students. |
| 0:03.2 | My name is Zach Olson and thank you for downloading this week's episode of the EM Clerkship Podcast. |
| 0:11.0 | Big topic this week. |
| 0:12.6 | Holy crap, we need to just get started. |
| 0:16.4 | This week, we're still going through our organized mnemonic. |
| 0:19.7 | Oh, shit. |
| 0:20.6 | Grab the braslow. This is the |
| 0:22.3 | algorithm that we run through in our brain whenever that sick child or that sick neonate |
| 0:28.4 | comes into the emergency department. And today is H. Heart. And the big, big thing that you need |
| 0:37.0 | to remember today, the big treatment is |
| 0:40.6 | prostaglandin. Sick neonates that are less than 30 days old and they're in shock and they look bad, |
| 0:49.6 | you need to consider giving prostaglandin. Prostaglandin opens up the ductus arteriosis, which temporizes |
| 0:58.6 | ductal dependent lesions, which we're going to cover. Just remember prostaglandin. But let's back up, |
| 1:06.5 | because today we're actually covering three general categories of cardiac problems. |
| 1:11.9 | So hang with me. |
| 1:13.0 | Those three categories are the five cyanotic heart lesions, ductal dependent lesions in that first |
| 1:20.4 | month of life where you're given those prostaginol anins and then congestive heart failure. |
| 1:25.4 | Those are the three categories to know. |
| 1:29.4 | Starting with cyanotic heart lesions, |
| 1:32.1 | they can present first couple days of life |
| 1:34.6 | all the way through infancy, |
| 1:36.0 | and there are five. |
... |
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