Topics Discussed: acquired heart disease; anti-arrhythmia agents; aortic coarctation; aortic valve stenosis; arterial switch operation; artificial cardiac pacemaker; atrial inversion operation using atrial wall; atrial septal defect; atrioventricular septal defect; bacterial endocarditis; balloon valvuloplasty; banding of pulmonary artery; blalock-taussig shunt; bradycardia; cardiac arrhythmia; cardiac surgery procedures; cardiology; cardiomyopathy; cardiomyopathy, dilated; cardiovascular disease; cardiovascular dysfunction; chest pain; congenital heart disease; congenital heart disease, acyanotic; creation of shunt of ascending aorta to pulmonary artery; cyanotic congenital heart disease; damus-stansel-kaye operation; ebstein anomaly; ecg normal; electrocardiogram; electrolyte; endocardial cushion defects; endocarditis prophylaxis; excess fluid volume; fontan procedure; glenn shunt, classic; heart valve repair; hypertrophic cardiomyopathy; hypoplastic left heart syndrome; jones criteria; konno aortoventriculoplasty; left ventricular noncompaction; myocarditis; patent ductus arteriosus; pericardial disease; pericardial effusion; pericarditis; pericarditis, acute; pericarditis, constrictive; pharmaceutical preparations; pulmonary atresia with intact ventricular septum; pulmonary valve stenosis; rastelli operation in repair of transposition of great vessels; repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure); restrictive cardiomyopathy; rheumatic fever; sinus tachycardia; structural disorder of heart; supraventricular tachycardia; tachycardia; tetralogy of fallot; total anomalous pulmonary venous return; transposition of great vessels; tricuspid atresia; truncus arteriosus; ventricular septal defect.
Excerpt:"See Chapter 32.Inflammatory infiltrate of the myocardium with necrosis and degeneration of adjacent cardiac myocytes. Most cases in the developed world are of viral etiology (NEJM 1985;312(14):885). Impaired contractility (acute) leads to ventricular dilation (subacute and chronic), often with acute heart failure.(Ped Clin N Am 2006;53(1):85)Myocardial dysfunction
- Examples: Myocarditis, cardiomyopathies
- Systolic (contraction) and diastolic (relaxation) dysfunction may be present in combination or separately. Cardiac output is limited because of ventricular dysfunction.
- Signs and symptoms: Tachypnea, orthopnea, respiratory distress, poor perfusion, hepatomegaly, vomiting, anorexia.
- Treatment (systolic dysfunction): Afterload reduction (ACE inhibitors), -blockers, or both. Diuretic therapy helpful for volume overload. IV inotropic support may be necessary for severe, acute symptoms or end-organ dysfunction.
- Examples: ASD, VSD, CAVC, PDA, unobstructed TAPVC, truncus arteriosus, single ventricle with pulmonary blood flow.
- L R shunting causes excess pulmonary blood flow (pulmonary..."
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