Please enable JavaScript.
Coggle requires JavaScript to display documents.
Pediatric Heart Failure (Diagnostic (Laboratory (DL, AGD, elektrolit,…
Pediatric Heart Failure
Prevalence
10-33% with congenital heart disease
Increase risk of mortality >20x
Most common etiology
CHD
Dilated cardiomyopathy
Definition
Ventricular dysfunction
Volume overload
Pressure overload
Stratification in Pediatric (ISHLT)
Stadium A
High risk for HF
Asymptomatic
Ex
Univentricular
CCTGA
Duchenne musc Dystrophy
DCM
Anthracycline exposure
Renal failure
Stadium B
Abnormal structural and function
Asymptomatic
Ex:
LV dilatation
Noncompact LV
Stadium C
Abnormal function and structural
With symptom
Stadium D
End-of life care. Need inotropic
Pathophysiology: Decrease CO
Decrease renal perfusion
RAAS release
AT2 release to AT1
Increase aldosteron
Vasoconstriction (increase afterload)
Increase BP
Increase reabsorption of Na and water (Increase preload)
Apoptosis/Myocardial fibrosis
Myocardial Dysfunction
Chronic Heart failure
Increase clearance by neprilysin
Baroreceptor stimulation
Sympathetic activation
Increase chronothropic
Inc contractility
Inc Vasconc (afterload inc)
Myocardial Toxicity
Natriuretic peptide
Increase Neprilysin (ANP, BNP)
Increase NP receptor density
Vasodilatation
Decrease BP
Decrease sympathetic tone
Diuresis
Diagnostic
Anamnesis
Physical exam
Laboratory
DL
AGD
elektrolit
Renal function
Liver function
Lactate
Natriuretic peptida
troponin
CXR
Cardiomegaly
Lung edema
ECG
Arrhytmia
Ischemia
AV block
Echo
Structural and functional
Ventricular wall
Systolic fynction
Diastolic LV
PA pressure
MRI
Evaliate the specific structure of Cardiomyopathy/CHD
Cath
Hemodynamic parameter
CO
PVR
Management
Caring for the cause
Caring for the trigger
Rheuma reactivation
IE
Bronchopneumonia
Anemia
Electrolyte imbalance
Arrhytmia
Lung embolism
Drug interaction
Drug intoxication
Caring for the congestion
Decrease lung and systemic congestion
Decrease afterload
Increase contractility