Etiology congenital heart defects ateriovenous malformations cardiomyopathy arrhythmias acute hypertension anemia...
Etiology
- congenital heart defects
- ateriovenous malformations
- cardiomyopathy
- arrhythmias acute hypertension anemia cor pulmonale
Pathophysiology
see Cardiology Notes
Symptoms
Infant:
- feeding difficulties,
- easy fatigability
- exertional dyspnea
- diaphoresis when sleeping or eating,
- respiratory distress
- vomiting
- lethargy
- cyanosis
Child:
- decreased exercise tolerance
- fatigue
- decreased appetite
- failure to thrive
- respiratory distress, syncope
- frequent URTIs or "asthma" episodes
- orthopnea, paroxysmal nocturnal dyspnea, edema are uncommon in children
Physical Findings
- four key features: (2 tachy, 2 megaly)
- tachycardia
- tachypnea
- cardiomegaly
- hepatomegaly
- failure to thrive
- respiratory distress, wheeze, crackles, cyanosis and clubbing
- alterations in peripheral pulses, four limb blood pressures
- dysmorphic features associated with congenital syndromes
Management
- general: sitting up, oxygen, sodium and water restriction, increased
caloric intake - pharmacologic:
- diuretics
- inotropic agents
- afterload reduction
- correction of underlying cause
