pedsHeartAndCirculationJan05

pedsHeartAndCirculationJan05 - Pediatric Fundamentals Heart...

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Pediatric Fundamentals – Heart and Circulation Embryology 1. Cardiovascular system begins forming at 3 weeks (diffusion no longer adequate) 2. Angiogenetic cell cluster and blood islands -> intraamniotic blood vessels 3. Heart tube 4. Heart begins to beat 22 – 23 days 5. Heart looping -> 4 chambers, 27 – 37 days 6. Valves 6 – 9 weeks
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Pediatric Fundamentals - Growth and Development Cardiovascular system In utero circulation placenta -> umbilical vein (UV)-> ductus venosus (50%) -> IVC -> RA -> foramen ovale (FO) -> LA -> Ascending Ao -> SVC -> RA -> tricuspid valve -> RV (2/3rds of CO) -> main pulmonary artery (MPA) -> ductus arteriosus (DA) (90%) -> descending Ao -> umbilical arteries (UAs)->
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Pediatric Fundamentals – Heart and Circulation Transitional circulation Placenta Out and Lungs In PVR drops dramatically (endothelial-derived NO and prostacyclin) FO closes DA closes 10-12 hours to 3 days to few weeks prematures: closes in 4-12 months PFO potential route for systemic emboli DA and PFO routes for R -> L shunt in PPHN
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pedsHeartAndCirculationJan05 - Pediatric Fundamentals Heart...

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