Lecture Notes: Acquired Heart Diseases

Introduction

• Acquired heart diseases occur after birth.
• Focus on common acquired heart diseases.

Cardiac Dysrhythmias

• Importance of understanding pediatric cardiac rhythms.
• Nurses must know normal heart rates for different age groups.
• Recognize abnormal heartbeat rates or rhythm.
• Apical rate should be counted for a full minute and compared to radial rate.
  • High or low heart rates are suspicious.

Bradycardia

• Could indicate a heart block.
• Need knowledge of normal heart rates to identify abnormalities.

Supraventricular Tachycardia (SVT)

• Most common tachydysrhythmia in children.
• Rapid regular heart rate (200-300 bpm).
• Sudden onset, variable duration, ends abruptly.
• Clinical signs: poor feeding, irritability, paler, palpitations, dizziness, chest pain.
• Treatment:
  • Vagal maneuvers (ice application, Valsalva maneuver).
  • Adenosine through rapid IV push.
  • Esophageal overdrive pacing or synchronized cardioversion if other methods fail.

Kawasaki Disease

• Acute systemic vasculitis of unknown cause.
• Affects children under age 5.
• Risk of coronary artery complications.
• Diagnostic Criteria:
  • Fever for 5 days + four of five clinical symptoms (changes in extremities, conjunctivitis, oral changes, rash, cervical lymphademapathy).
• Treatment:
  • High-dose IVIG and aspirin.

MIS-C (Multisystem Inflammatory Syndrome in Children)

• Associated with COVID-19.
• Similar treatment to Kawasaki disease.
• Criteria:
  • Fever over 38°C for 24 hours.
  • Evidence of inflammation and multi-system involvement.
  • Positive for COVID-19 infection or exposure.

Rheumatic Heart Disease

• Result of abnormal immune response to group A strep infection.
• Affects joints, skin, brain, heart.
• Clinical Manifestations:
  • Carditis, polyarthritis, subcutaneous nodules, erythema marginatum.
• Treatment:
  • Penicillin, anti-inflammatory therapy, supportive care.

Anaphylaxis

• Acute syndrome from allergen interaction.
• Symptoms: uneasiness, bronchial constriction, shock.
• Treatment:
  • Early recognition, epinephrine administration, airway management.

Shock

• Circulatory failure, inadequate tissue perfusion.
• Types:
  • Hypovolemic, distributive, cardiogenic, obstructive.
• Treatment:
  • Oxygenation, fluid administration, cardiac output improvement (vasopressors).
• Ensure airway and oxygenation.

Note: These notes are a summary of key points from the lecture and should be used as a study aid.