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Heart Failure VII: Nursing Interventions

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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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A Pipeline to Characterize Structural Heart Defects in the Fetal Mouse
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Fetal interventions for structural heart disease.

David N Schidlow1, Lindsay Freud2, Kevin Friedman3,4

  • 1Children's National Heart Institute, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Echocardiography (Mount Kisco, N.Y.)
|December 30, 2017
PubMed
Summary
This summary is machine-generated.

Fetal cardiac intervention (FCI) can preserve biventricular circulation for complex congenital heart defects, potentially avoiding single-ventricle palliation. Detailed fetal echocardiography is crucial for selecting appropriate candidates for this innovative treatment.

Keywords:
congenital heart defectsfetal echocardiography

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Area of Science:

  • Cardiology
  • Fetal Medicine
  • Pediatric Surgery

Background:

  • Congenital heart defects like aortic stenosis and pulmonary atresia can lead to hypoplastic heart syndromes.
  • Current management often involves single-ventricle palliation, which has significant long-term complications.
  • Fetal cardiac intervention (FCI) presents a potential alternative to alter in utero development.

Purpose of the Study:

  • To review the role of FCI in specific congenital heart lesions.
  • To highlight the importance of fetal echocardiography in patient selection.
  • To discuss the pathophysiology, rationale, and outcomes of FCI for selected conditions.

Main Methods:

  • Review of existing literature on FCI for hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum.
  • Emphasis on echocardiographic assessment techniques for identifying suitable candidates.
  • Analysis of pathophysiology, intervention rationale, and patient selection criteria.

Main Results:

  • FCI may enable biventricular circulation maintenance in evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum.
  • Intervention can potentially ameliorate in utero pathophysiology for hypoplastic left heart syndrome with intact atrial septum.
  • Successful FCI requires precise echocardiographic evaluation for optimal patient selection.

Conclusions:

  • Fetal cardiac intervention is a promising approach for specific congenital heart defects.
  • Careful fetal echocardiographic assessment is paramount for successful FCI outcomes.
  • FCI offers the potential to improve long-term prognosis by preserving biventricular physiology.