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Cardiovascular 

Cardiovascular
Chapter:
Cardiovascular
DOI:
10.1093/med/9780197525227.003.0004
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date: 06 December 2021

The cardiovascular chapter focuses on signs of shock—when cardiac output cannot meet the oxygen and energy requirements of vital organs—central cyanosis, and cardiac arrythmia. It identifies and prioritizes the need for immediate stabilization, cardiorespiratory support, and management. Stabilization includes clinical assessment of circulation, pulse oximetry, and determining whether cyanosis can respond to oxygen. The difference between cyanosis of cardiac and respiratory origins is explained and illustrated, along with implications for diagnosis and treatment. Anatomical abnormalities of the heart and abnormal heart rhythms are considered separately. Specific conditions are described and illustrated: hypoplastic left heart syndrome, coarctation of the aorta, persistent pulmonary hypertension of the newborn, cyanotic heart disease, transposition of the great arteries, tricuspid atresia, and total anomalous pulmonary venous return. Related procedures and treatment modalities (e.g., volume expansion, prostaglandin E1, transfusion, or intravenous antibiotics for suspected sepsis) are described. Three case scenarios highlight differences between shock and circulatory instability without shock.

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