Ventricular septal defects. A case study and discussion.

Ventricular septal rupture is a serious complication of acute myocardial infarction (MI) that generally produces progressive circulatory failure and rapid deterioration. Prompt diagnosis followed by surgical repair with peri-operative circulatory support is often life-saving (Mazeika et al 1994). The following is an account of a patient that I cared for, whilst working on the coronary care unit (CCU) as part of an ENB 125 course. The patient was originally admitted with an inferior MI and went on to develop a ventricular septal defect (VSD).

The pediatric cardiovascular surgery patient: a case study.

The pediatric cardiovascular surgery patient has many needs, based not only on the complexity of the surgical procedure, but also on anatomic, physiologic, and emotional differences. These differences have implications for nursing care in the postoperative period. This article focuses on the special needs of a child who required correction of a congenital heart defect. The specialized knowledge required by the pediatric critical care nurse to make accurate assessments of the child's status and to intervene appropriately are emphasized. Issues surrounding the care of the family of the child who experiences cardiac surgery are highlighted.

Ventricular septal and free wall rupture complicating acute MI.

This article discusses rupture of the free wall of the left ventricle and ventricular septal defect (VSD). Although both entities occur infrequently, they remain prominent causes of death from acute myocardial infarction (AMI). Rupture of the free wall varies from an acute tear to a slow, incomplete, or subacute rupture. A VSD resulting from an AMI may be simple or complex. A simple rupture is a direct opening in the ventricular system. A complex rupture ascribes an undulating course. Although VSD is potentially amendable to surgical therapy, free wall rupture is usually immediately fatal. Because rapid identification with aggressive treatment potentially influences patient outcome, cardiovascular nurses need to be able to rapidly identify patients experiencing these cardiac rupture syndromes. Nurses provide the important physiologic and psychosocial support that is necessary for patient survival and successful adaptation.

Ventricular septal defect.

This article has discussed the ventricular septal defect, its occurrence, physiology, and therapy, and nursing concerns. The VSD, a communication allowing left-to-right shunting of blood at the ventricular level, is the most common congenital heart defect. Surgical correction is often required for large defects before the age of 12 months, and primary correction is now considered standard procedure. Small defects usually close spontaneously, and moderate defects are closely monitored for signs indicating the need for surgical intervention. Nursing care begins with child and family assessment and evaluation of the strengths and weaknesses of the family system. The child's developmental level is a major consideration in formulating interventions for his benefit. Play therapy is a useful vehicle in relating to the child in a nonthreatening manner preoperatively and in allowing the child to work through his hospitalization postoperatively. Maintaining the physical integrity of a child just out of the operating room is a challenge. Continuing support of the family system is a significant aspect of nursing's responsibility toward child and family. Discharge planning and intervention strive to prepare the family for the transition from hospital to home both physically and emotionally.