Preparing to Treat Patients With Pediatric-Acquired Heart Disease

Nurses in pediatric heart centers often encounter patients with pediatric-acquired heart disease. Join speaker Megan K. McMahon on Monday from 12:15-1:15 p.m., in room 254, to explore the risk factors, etiology and pathophysiology of acquired heart diseases in the pediatric population.

During “Update on Pediatric-Acquired Heart Disease,” McMahon will review common pediatric heart conditions, including cardiomyopathy, endocarditis, Kawasaki disease, Lyme carditis, myocarditis and rheumatic heart disease. Diagnostic methods, treatment and specific nursing interventions will also be discussed.

“Timing is everything,” says McMahon, a registered nurse at Boston Children’s Hospital. “Prompt diagnosis and treatment helps to lessen the long-term negative effects of these diseases.”

McMahon will cover common risk factors for pediatric-acquired heart disease, including patients with known congenital heart disease and artificial heart valves who are at risk for endocarditis, cardiomyopathy and myocarditis. For healthy patients, a history of viral, bacterial or fungal infection is a risk factor for myocarditis; a history of strep throat infection is a risk factor for rheumatic heart disease; and a history of Lyme disease is a risk factor for Lyme carditis.

McMahon says nurses should trust their physical assessment skills and recognize the importance of relaying even minute changes. It is important to closely monitor vital signs and EKG rhythms, anticipating possible arrhythmias or ST-segment changes that may occur with any acquired heart disease.

“Having keen physical assessment skills is crucial when monitoring heart sounds and lung sounds,” McMahon says. In addition to color, warmth and perfusion, many of the acquired heart diseases have characteristic skin manifestations.

Other considerations for nurses include administering appropriate medications and educating families on the need for long-term management of some of these diseases.

After the session, attendees can share this information at new-hire orientations, daily huddles and lunch-and-learn programs for anyone working in pediatrics. Providing a refresher, whether in the emergency department, inpatient floor units or the intensive care unit, is helpful, since many of these diseases are quite rare and are not encountered every day.

“Pediatric-acquired heart diseases come in waves,” McMahon says. “It is less common for us to care for acquired heart disease than congenital heart disease, so it is important to be aware that these children could be coming through our doors, and it is important to be prepared to care for them.”