Causes of heart disease in infants and young children:
- congenital heart disease: 1% of newborns
- myocarditis
- metabolic / storage diseases
- endocardial fibroelastosis
- cardiomyopathy
- hypertrophic
- congestive
- constrictive
Principles of management of heart disease in infants and young children:
- rest + O2 ⇒ ⇒ surgery
- fluids / feeds
- circulatory support
- IV dopamine
- Digoxin
- diuresis
- Lasix
- potassium
- treat infection promptly
- correct acidosis
- PGE1 (duct closure)
- bicarbonate
Congenital heart disease¹
Pulmonary hypertension is due to a vasoactive pulmonary bed, the response of which determines the clinical findings and prognosis in congenital heart disease.
- ASD
- VSD
- Tetralogy of Fallot
- Ebstein’s Anomaly
- Patent ductus arteriosus
- Bicuspid aortic valve
- Asymmetric septal hypertrophy
Right-to-left shunts are associated with arterial oxygen desaturation and cyanosis, the degree being related to magnitude of pulmonary blood flow, decreased (Tetralogy) or increased (transposition of great vessels). Eisenmenger’s syndrome or physiology is a term applied to a condition which
occurs in several congenital anomalies where pulmonary hypertension develops; a previous left-to-right shunt reverses to right-to-left. The systemic blood then is desaturated with non-oxygenated blood, cyanosis and clubbing develop, and dyspnea
and fatigue worsen. The goal of surgical treatment is to intervene before the syndrome occurs because when well established, it is irreversible and fatal.
Works cited
- Jarolim, DR 1996, Internal Medicine, 2nd ed. 1996., Springer New York, New York, NY, doi: 10.1007/978-1-4612-2370-2.
Further
Wren C, Richmond S, Donaldson L. Presentation of congenital heart disease in infancy: implications for routine examination. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F49-53. doi: 10.1136/fn.80.1.f49. PMID: 10325813; PMCID: PMC1720871.
