Congenital Heart Defects: Obstructed and Mixed Blood Flow

Introduction

• Presenter: Cathy from Level Up RN
• Focus: Congenital heart defects causing obstructed and mixed blood flow
• Includes a quiz to test knowledge

Obstructed Blood Flow Defects

Coarctation of the Aorta

• Description: Narrowing of the aorta
• Implications: Upper extremities receive adequate blood; lower extremities do not
• Signs & Symptoms:
  • Upper extremity hypertension
  • Bounding pulses in upper extremities
  • Weak pulses, cool skin, and pallor in lower extremities
• Treatment:
  • Balloon angioplasty or stents
  • Surgical removal of narrowed section
  • Hypertension management with medications

Aortic Stenosis

• Description: Narrowing of the aortic valve
• Implications: Decreased blood flow to the whole body
• Signs & Symptoms:
  • Hypotension
  • Decreased pulses
  • Tachycardia
  • Poor feeding and exercise intolerance
• Treatment:
  • Balloon dilation or valvotomy

Pulmonary Stenosis

• Description: Narrowing of the pulmonary valve
• Implications: Obstructs blood flow to the lungs
• Signs & Symptoms:
  • Systolic ejection murmur
  • Cyanosis
  • Cardiomegaly
  • Heart failure
• Treatment:
  • Balloon dilation or valvotomy

Mixed Blood Flow Defects

Transposition of the Great Arteries (TGA)

• Description: Reversed connections of the aorta and pulmonary artery
• Implications: Deoxygenated blood pumped to body; oxygenated blood cycled back to lungs
• Signs & Symptoms:
  • Heart failure
  • Shortness of breath
  • Cardiomegaly
  • Cyanosis, hypoxia, murmurs
  • Fatigue and poor growth
• Treatment:
  • Prostaglandins to maintain patent ductus arteriosus (PDA)
  • Surgery within the first week of life

Total Anomalous Pulmonary Venous Connection (TAPVC)

• Description: Pulmonary veins connect to right side of heart
• Implications: Oxygenated blood returns to lungs
• Signs & Symptoms:
  • Cyanosis
  • Dyspnea
  • Poor feeding
• Treatment:
  • Surgical repair to correct vein connections

Truncus Arteriosus

• Description: Single vessel instead of separate pulmonary artery and aorta
• Implications: Mixing of blood due to VSD (Ventricular Septal Defect)
• Signs & Symptoms:
  • Heart failure
  • Murmurs
  • Cyanosis
  • Poor feeding
• Treatment:
  • Surgical repair within first few months

Hypoplastic Left Heart Syndrome

• Description: Underdevelopment of the left side of the heart
• Implications: Inadequate systemic circulation
• Signs & Symptoms:
  • Cyanosis
  • Heart failure
  • Cold extremities
  • Lethargy
• Treatment:
  • Prostaglandins to maintain PDA
  • Three-stage surgery: Norwood procedure, Glenn shunt, Fontan procedure

Quiz Questions

1. Murmur with Pulmonary Stenosis: Systolic ejection murmur
2. Defect with Upper Extremity Hypertension: Coarctation of the aorta
3. Reversed Arterial Connections: Transposition of the great arteries

Closing Remarks

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