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Abnormal Rhythm in Children PowerPoint Presentation

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Description : This presentation is made for some pediatric cardiology emergencies. these are real cases presented to our department

Tags : pediatric cardiology,cardiology,Abnormal Rhythm,Abnormal,Rhythm

Published on : Feb 17, 2023 | Views : 980 | Downloads : 0

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Slide 1-

Emergencies in paediatric cardiology Sameh Abdulsamea
Slide 2-

What to cover today Differences between adults and children Fetal circulation Assessment of the cardiovascular system Different cardiac scenarios and how to approach
Slide 3-

Children are not small adults
Slide 4-

Quiz If I tell you the body surface area of 30 kg is 1m2 What is the surface area of 3 kg baby? Body surface area = √wt x ht/3600 What is the blood volume of 5 kg child? What is the tidal volume of 5 kg baby
Slide 5-

Fetal Circulation
Slide 6-

Assessment of CVS Look (well, dysmorphic, …) Colour Observations: Saturation (pre and post ductal saturation) Femoral pulse (all other pulses) Respiratory assessment Then local cardiac examination: HR, heart sounds, murmurs, gallop, muffled heart sounds, What is Beck’s triad)
Slide 7-

Shall we start?
Slide 8-

Two facts to remember please pG Patency pda Oxygen occlude pda
Slide 9-

Scenario 1 Term baby, born by ventouse assisted delivery. Has been breast feeding well, was about to be discharged and found to have post ductal saturation of 75% (with a preductal of 92%). Looked a bit dusky around the lips. Heart sounds showed a faint systolic murmur on the left parasternal margin. What is your first step to do? Why there is different saturation between pre and post ductal probes What other assessment you like to do
Slide 10-

What are duct dependent lesions Target saturation is 75-80% (to maintain pulmonary:systemic circulation of 1:1)
Slide 11-

Scenario 2 10 days old baby presented mottled, floppy, saturation of 98%. Born at term, SVD, no problems during pregnancy or after delivery. Poor pulse in the femoral arteries Very difficult access
Slide 12-

Normal blood pressure 50th precentile systolic blood pressure= 90 mmHg + (2 x age in years)
Slide 13-

Please think about scalp veins or right upper limb access (IO in the tibia may not be adequate)
Slide 14-

Scenario 3 Term baby, antenatally diagnosed with Fallot’s Tetralogy. Found to have a pre and post ductal saturation of 97%. Pink and well perfused. Feeding well. What do you like to do? Would you worry about anything?
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Slide 16-

Fallot’s Pink Less cyanosed Early failure Blue Early cyanosis Did not fail easily
Slide 17-

Scenario 4 15 years old girl presented with abdominal pain and vomiting. She was pyrexial (39.5). She looked overall tired and not interested in eating or drinking. She was referred to the surgical team for ? Appendicitis. What else do you like to ask about? What is with and against appendicitis? What other differentials do you like to suppose? What investigations do you like to ask about?
Slide 18-

She was admitted overnight, found to be still not well, and temperature was still above 39. Surgeons excluded appendicitis as US was normal and it was mainly her epigastric region which was normal. She tried to go the toilet but fainted. BP 87/50, HR 125/m, RR 30/m, satruation 97% What is your functional diagnosis? And what is your provisional aetiologic diagnosis?
Slide 19-

Scenario 5 4 weeks old baby presented with poor feeding and being mottled. Born at term, no problems during pregnancy or after delivery. Has been generally well and thriving. How do you like to approach? What questions and clinical findings do you look for? What 3 differentials will you have in mind?
Slide 20-

Normal ECG in babies
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