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% Document Info
\author{Dani (Dan\_Niel)}
\pdfinfo{
  /Title (alteration-on-oxy-cardiac-acyanotic.pdf)
  /Creator (Cheatography)
  /Author (Dani (Dan\_Niel))
  /Subject (Alteration on Oxy (cardiac acyanotic) Cheat Sheet)
}

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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Alteration on Oxy (cardiac acyanotic) Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Dani (Dan\_Niel)} via \textcolor{DarkBackground}{\uline{cheatography.com/131883/cs/26611/}}}
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\noindent
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Dani (Dan\_Niel) \\
  \uline{cheatography.com/dan-niel} \\
  \end{tabulary}
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 19th February, 2021.\\
   Updated 19th February, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{The Human Heart}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/dan-niel_1613311772_431e462707925dc8ec32274fdded3d12.png}}} \tn 
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\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Risk Factors}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Cardiac development occurs very early in fetal life} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• maternal factors (rubella, alcohol, diabetes mellitus)} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Genetic factors (history of congenital heart disease)} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Trisomy 21 (Down syndrome)} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Presence of other congenital anomalies or syndrome.} \tn 
% Row Count 9 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Atrial septal defect (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Opening in the atrial septum permitting free communication of blood between the 2 atria} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Ostium primum (ASD1)}} open at lower end of septum} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Ostium secundum (ASD2)}} open near the center septum} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Pathophysiology}}} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Blood flows from left to right (oxy to deoxy) because of the stronger contraction of the left side of the heart, causing an increase volume in the right.} \tn 
% Row Count 11 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Right atrium enlarged, ventricular hypertrophy and increased pulmonary artery blood flow.} \tn 
% Row Count 13 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs and symptoms}}} \tn 
% Row Count 14 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Dyspnea on exertion, fatigability, mild growth failure} \tn 
% Row Count 16 (+ 2)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Cyanosis does not occur unless CHF is present.} \tn 
% Row Count 17 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Diagnosis}}} \tn 
% Row Count 18 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•ECG with color flow doppler reveal enlarged right side of the heart} \tn 
% Row Count 20 (+ 2)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Cardiac catherization reveal separation in atrial septum} \tn 
% Row Count 22 (+ 2)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatments}}} \tn 
% Row Count 23 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Surgical or catherization laboratory for ASD2} \tn 
% Row Count 24 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Surgery : sutured, completed with catheterization} \tn 
% Row Count 26 (+ 2)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Cardiopulmonary bypass : open heart surgery} \tn 
% Row Count 27 (+ 1)
% Row 16
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Silastic or Dacron patch : sutured in place} \tn 
% Row Count 28 (+ 1)
% Row 17
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Complications}}} \tn 
% Row Count 29 (+ 1)
% Row 18
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Infectious endocarditis and eventual heart failure} \tn 
% Row Count 31 (+ 2)
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\columnbreak
\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Atrial septal defect (Acyanotic) (cont)}}  \tn
% Row 19
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• can cause emboli during pregnancy if not treated} \tn 
% Row Count 2 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{1.79172 cm} x{3.18528 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Aortic Stenosis (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Narrowing at above or below the aortic valve.} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Supravalvular}} & ascending aorta. least common \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
{\bf{Valvular}} & most common \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
{\bf{Subvalvular}} & subaortic. left outflow tract. \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs \& Symptoms}}} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Mild: exercise intolerance, easy fatigability, asymp.} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Moderate: Chest pain, dyspnea, diziness \& syncope} \tn 
% Row Count 11 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Severe: weak pulses, left failure, hypotension, tachy and activity intolerance chest pain and sudden death.} \tn 
% Row Count 14 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatment}}} \tn 
% Row Count 15 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Balloon valvuloplasty as the standard treatment} \tn 
% Row Count 16 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Mild: activity should not be restricted} \tn 
% Row Count 17 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Mod-severe: no competitive sports} \tn 
% Row Count 18 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Cardiac catheterization: Balloon dilation} \tn 
% Row Count 19 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Surgical valvotomy: if closed procedure doesn't work. done to older pts. when severe calcium deposits further obstruct the valve.} \tn 
% Row Count 22 (+ 3)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Beta blocker or calcium channel blocker} \tn 
% Row Count 23 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Antibiotic prophylaxis against endocarditis} \tn 
% Row Count 24 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Acyanotic (Congenital heart defect)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Increased pulmonary blood flow}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Atrial septal defect} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Ventricular septal defect} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Patent ductus arteriosus} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Atrioventricular canal} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Obstruction to blood flow from ventricles}}} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Coarction of the aorta} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Aortic stenosis} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Pulmonic stenosis} \tn 
% Row Count 9 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.14011 cm} x{2.83689 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Diagnostic Tests}}  \tn
% Row 0
\SetRowColor{LightBackground}
Echocardiogram & Cardiac Catheterization \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Electrocardiogram} & Chest X-ray \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Echocardiography & MRI \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{3.43413 cm} x{1.54287 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Ventricular Septal Defect (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Abnormal opening in ventricular septum, allows free communication between R \& L ventricles} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Small to moderate VSD:}} 3-6 mm, asymptomatic} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Moderate to large VSD:}} symptomatic, require repair} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{Signs \& Symptoms}} & 4-8 weeks \tn 
% Row Count 6 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Easy fatigue, failure to thrive, dyspnea} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• A loud, harsh murmur on left sternal border (3rd/4th )} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Thrill may be palpable, respiratory infections} \tn 
% Row Count 10 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatment}}} \tn 
% Row Count 11 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Small VSD: no surgical intervention, just reassurance} \tn 
% Row Count 13 (+ 2)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Symptomatic VSD: meds, afterload reducers, diuretics} \tn 
% Row Count 15 (+ 2)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Moderate: cardiac catheterization} \tn 
% Row Count 16 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Larger: 3mm open heart surgery} \tn 
% Row Count 17 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Exceptionally large: Silastic or Dacron patch} \tn 
% Row Count 18 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Complications}}} \tn 
% Row Count 19 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Cardiac or Heart failure} \tn 
% Row Count 20 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Endocarditis due to recirculating blood flow} \tn 
% Row Count 21 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Indication for surgery:}} Large vsd with uncontrolled symptomatology, Ages 6-12 mo. with large vsd \& pulmonary HTN}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Pulmonary Stenosis (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Narrowing of the pulmonary valve or PA that results in the obstruction of blood flow from the ventricles.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs \& Symptoms}}} \tn 
% Row Count 4 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Mild : Asymptomatic, split 2nd heart sound w/ delay} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Heart failure (right) \& cyanosis with severe} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Systolic ejection murmur, Right ventricular enlargement} \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Exercise intolerance} \tn 
% Row Count 10 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatment}}} \tn 
% Row Count 11 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Mild: No intervention needed, close follow up} \tn 
% Row Count 12 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Mid-severe: requires relieve of stenosis} \tn 
% Row Count 13 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Balloon valvuplasty, treatment of choice} \tn 
% Row Count 14 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Surgical valvotomy is also a consideration.} \tn 
% Row Count 15 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Open-heart needed only for more complex valve anomaly.} \tn 
% Row Count 17 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Cyanotic (Congenital heart defect)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Decreased pulmonary blood flow}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Tetralogy of Fallot} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Tricuspid atresia} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Mixed blood flow}}} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Transposition of great vessels} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Truncus arteriosus} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Total anomalous pulmonary venous return} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Hypoplastic left heart syndrome} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Atrioventricular Septal Defects (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Also called an {\bf{endocardial cushion defect}}, results from incomplete fusion of the endocardial cushion. At the septum of the heart} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Consists of a low atrial septal defect continuous with ventricular septal defect \& clefts of mitral \& tricuspid, creating a large central AV valve} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Allows blood to flow between all heart chambers.} \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs and Symptoms}}} \tn 
% Row Count 9 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•CHF in infancy, Failure to thrive, recurrent infections} \tn 
% Row Count 11 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Exercise intolerance, easy fatigability} \tn 
% Row Count 12 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Cardiac enlargement on CX-ray} \tn 
% Row Count 13 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Late cyanosis from pulmonary vascular w/ R to L shunt} \tn 
% Row Count 15 (+ 2)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatment}}} \tn 
% Row Count 16 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Surgery is always required} \tn 
% Row Count 17 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Treatment of congestive symptoms.} \tn 
% Row Count 18 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Pulmonary banding maybe req. in premature or \textless{}5kg} \tn 
% Row Count 20 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Patent Ductus Arteriosus (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Conduit between pulmonary artery \& aorta fails to close and results in increased pul. blood flow (L to R shunt)} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Ductus Arteriousus}} fetal structure that connects PA to the aorta. Closure at first breath and is incomplete bet. 7 to 14 days. closure not until 3 mos.} \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• blood will shunt from aorta (oxy) to the PA (deoxy) because of the increased pressure in the aorta.} \tn 
% Row Count 10 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs \& Symptoms}}} \tn 
% Row Count 11 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Small PDA: usually asymptomatic} \tn 
% Row Count 12 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Large PDA: symptoms of CHF \& growth restriction} \tn 
% Row Count 14 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Bounding arterial pulses, Widened pulse pressure} \tn 
% Row Count 16 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Enlarged heart, prominent apical impulse.} \tn 
% Row Count 17 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Classic continuous machinery systolic murmur} \tn 
% Row Count 18 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Mild-diastolic murmur at the apex.} \tn 
% Row Count 19 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatment}}} \tn 
% Row Count 20 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Indomethacin, inhibitor of prostaglandin synthesis} \tn 
% Row Count 22 (+ 2)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{• Surgical or catheter closure.} \tn 
% Row Count 23 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Same complications}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Coarction of the Aorta (Acyanotic)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Narrowing of aorta due to a constricting band} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Signs \& Symptoms}}} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Diminution or absence of femoral pulses} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Higher BP in upper extremities, headache, vertigo} \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Weak lower extremity pulses. decrease cardiac output} \tn 
% Row Count 7 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{• Epistaxis \& CVA not in children due to elevated BP} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Leg pain due to diminished blood supply} \tn 
% Row Count 10 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Treatments}}} \tn 
% Row Count 11 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Surgical intervention, prevent left vent dysfunction} \tn 
% Row Count 13 (+ 2)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Angoplasty is used by some centers} \tn 
% Row Count 14 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Balloon angioplasty is the procedure of choice} \tn 
% Row Count 15 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{•Antihypertensive -  High BP post-op} \tn 
% Row Count 16 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{•Antibiotic as prophylactic} \tn 
% Row Count 17 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}