Type of Anomaly Description Signs & Symptoms Complications

Treatment Nursing Interventions

Ventricular Septal Defect (VSD)Increased pulmonary blood flow, Acyanotic

Opening in the septum between the right and left ventricles of the heart

Dyspnea, tachypnea, fatigue after exertion, murmur,

Heart failure, ventricular hypertrophy, respiratory problems, bacterial endocarditis, failure to thrive, growth retardation

Up to 85% of VDSs close without treatment. Treat with dioxin and diuretics if congestive heart failure if present.Surgical repair

Monitor VS, Provide adequate nutrition, Monitor G & D, Provide for periods of rest,Prevent infections (antibiotic prophylaxis)Prepare child for tests/surgerySupport and educate family

Atrial Septal Defect (ASD)Increased pulmonary blood flow, Acyanotic

Opening in the septum between the right and left atria

Dyspnea, tachypnea, fatigue after exertion, murmur, clubbing,

Atrial arrhythmias, heart failure , respiratory infections, mitral valve prolapse, growth retardation

ASDs may close without treatment. Treat congestive heart failure with medication. Surgical repair may be needed.

Monitor VS, Provide adequate nutrition, Monitor G & D, Provide for periods of rest,Prevent infections (antibiotic prophylaxis)Prepare child for tests/surgerySupport and educate family

Patent Ductus Arteriosus (PDA) Increased pulmonary blood flow, Acyanotic

Failure of fetal ductus arteriosus to close after birth, resulting in a blood vessel connecting the pulmonary artery and the aorta

Bounding pulses, visible precordial pulsations, machine-like murmur, wide pulse pressure

Heart failure

Administration of Indomethacin to close the defect, if unsuccessful surgical repair may be needed

Monitor VS, Provide adequate nutrition, Monitor G & D, Provide for periods of rest,Prevent infections (antibiotic prophylaxis)Prepare child for tests/surgerySupport and educate family

Coarctation of the Aorta1:10,000 live births

Narrowing of the aorta at the transverse aortic

Blood pressures and O2 sats greater in the arms than in the legs,

Medical management of congestive heart failure; Digoxon & Diuretics

Assess for heart failure, hypotension, murmurSupport and educate family

Obstruction of blood flow leaving the heart, Acyanotic

arch or in the area of the ductus arteriosus

Strong brachial pulses, diminished femoral pulsesLower extremities cooler than upper extremities, irritability, dizziness, headache, fainting, epistaxis (nose bleeds from hypertension), CVA (stroke)

Surgical repair (by 2yrs old)

Tetralogy of Fallot (TOF)Decreased pulmonary blood flow, Cyanotic

Consists of four defects:1) Defect (ventral septal)VSD2) Right Ventricular Hypertrophy3)Overriding Aorta4)Pulmonary stenosis

Cyanosis, “tet spells”,Low SaO2 levels, clubbing, polycythemia, activity intolerance, fatigue, poor feeding, systolic murmur, growth retardation

Oxygen, MSo4, Inderal,Prostaglandin E1 to maintain a patent ductus arteriosus until surgery,Surgical repair (1-2 yrs old)

Prevention of “tet spells”, emboli, and endocarditis, Improve oxygenationSupport and educate family

Transposition of Great VesselsMixed blood flow, Cyanotic

The positions of the great arteries are reversed from the normal position. Aorta emerges from the right ventricle and the pulmonary artery emerges from the left ventricle

Cyanosis from birth, hypoxemia, dyspnea, tachycardia, cardiomegaly, hepatomegaly, heart failure, clubbing

This defect results in a medical emergency. Stabilization – treat acidosis.Administer prostaglandin E1 to maintain a patent ductus arteriosus until surgery is performed. Corrective surgery involves switching the position of the major vessels (1 wk – 3 months old)

Improve oxygenation, Medications as ordered, Supportive care until surgery

Support and educate family