HOLE IN THE HEART- ASD & VSD - ENGLISH
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HOLE IN THE HEART IN CHILDREN-
Hole in the heart is a congenital disorder, which are of two types-
Atrial Septal Defect- Every child is born with an opening between the
upper heart chambers. It’s a normal fetal heart opening that allows blood to
detour away from the lungs before birth. After birth, the opening is no longer
needed and usually closes within several weeks or months.
Sometimes the opening is larger
than normal and doesn’t close after birth. This condition is known as ASD.
Sign and symptoms of ASD depend upon size of the hole, in some cases, symptoms of ASD may not occur
until decades later. Some signs and symptoms that may occur includes:
Shortness of breath, especially
when exercising
Fatigue
Swelling of legs, feet or
abdomen
Heart palpitations or skipped
beats
Atrial fibrillation
Heart murmur, can be heard on auscultation.
Diagnostic investigations include-
Physical
examination-auscultaion of chest.
Echocardiography.
Chest X-ray.
Cardiac catheterization.
TREATMENT- If the opening is small, it doesn’t make the heart
and lungs work harder. Surgery and other treatments may not be needed. Small
ASDs that are discovered in infants often close or narrow on their own. There
isn’t any medicine that will make the ASD get smaller or close any faster than
it might do naturally.
However, if the ASD is large,
it can be closed with open-heart surgery, or by cardiac catheterization using a
device inserted into the opening to plug it.
Ventricular
Septal Defect- It is a type of
congenital heart defect. In a VSD, there is an abnormal opening in the
wall between the main pumping chambers of the heart (the ventricles). The blood
is shunted from left ventricle to right ventricle which results in overloading
of right ventricle.
Sign and symptoms of VSD Babies with VSDs may not have symptoms.
However, if the hole is large, the baby often has symptoms related to heart
failure.
The most common symptoms
include:
Shortness of breath
Fast breathing
Labored breathing
Paleness
Heart murmur, can be heard on auscultation.
Fast heart rate
Sweating while feeding
Frequent respiratory infections
Diagnostic investigations include-
Physical
examination-auscultaion of chest.
Echocardiography.
Chest X-ray.
Cardiac catheterization.
TREATMENT- If the defect is small, no treatment may be
needed. But the baby should be closely monitored by a health care provider.
Babies with a large VSD who have symptoms related to heart failure may need
medicine to control the symptoms and surgery to close the hole. Diuretic
medicines are often used to relieve symptoms of congestive heart failure.
If symptoms continue, even with
medicine, surgery to close the defect with a patch is needed. Some VSDs can be
closed with a special device during a cardiac catheterization, which
avoids the need for surgery. This is called transcatheter closure.
NURSING MANAGEMENT-
Ø -Observation
of respiratory and cardiac status is very important nursing care in ASD and VSD.
Ø - If
signs of respiratory distress are noted, the children should be placed in semi
fowler's position.
Ø -
all the medications are given on time, parents are involved in the care.
Ø
-
Intake output chart is maintained so that nutritional status and water balance
is assessed.
Ø
-
If surgery or catheterization procedure is scheduled, inform the parents about
the procedure and prepare them for surgery.
Ø
-
Anxiety level of parents is assessed and psychological support is provided to
alleviate anxiety.
Ø
Intake
output chart is maintained so that nutritional status and water balance is
assessed.
Ø
Surgical site care is provided with aseptic
technique to prevent infection and promote healing.
Ø
Other Nursing interventions – includes all nursing
care of hospitalized child that we have discussed in previous lecture under
heading Nursing care of hospitalized child in the lecture “Child Health
Nursing”.
Thank you sir
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