Chapter 37: Pediatric Cardiovascular Problems

Hyperlipidemia in children represents an important risk factor for future cardiovascular disease, with management focused on lifestyle modification and dietary changes rather than early pharmacological treatment. Heart failure in the pediatric population typically stems from congenital defects that impose abnormal volume or pressure demands on developing cardiac structures, presenting with distinctive signs such as excessive diaphoresis in infants, tachycardia, tachypnea, and differential presentations between right-sided and left-sided failure patterns. The chapter extensively covers congenital heart defects organized by hemodynamic consequences: acyanotic defects with increased pulmonary blood flow including atrial and ventricular septal defects and patent ductus arteriosus, obstructive defects such as aortic stenosis and coarctation of the aorta that restrict outflow, cyanotic defects with decreased pulmonary blood flow exemplified by tetralogy of Fallot and tricuspid atresia, and complex mixed defects like hypoplastic left heart syndrome and transposition of the great arteries that require early prostaglandin infusion or surgical intervention. Nursing management emphasizes fluid restriction, diuretic monitoring for electrolyte abnormalities, digoxin dosing and toxicity surveillance, and oxygen conservation strategies. The chapter addresses cardiac catheterization and surgical procedures with specific pre- and post-procedure protocols, including bleeding assessment and activity restriction. Additionally, the content covers acquired cardiovascular diseases in children, particularly rheumatic fever resulting from untreated streptococcal infection and diagnosed through Jones Criteria, and Kawasaki disease, an acute systemic inflammatory condition with potentially severe cardiac sequelae including coronary artery aneurysm formation, managed with immunoglobulin therapy and antiplatelet agents.