Children's National
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BTT Shunt Occlusion
Children's NationalThe patient is a 5-week-old baby girl with a prenatal diagnosis of hypoplastic left heart syndrome, status post-Norwood with a 3.5mm BTT shunt at DOL5. Her intraoperative and postoperative course was relatively unremarkable, and she had been in the hospital for two weeks post-op, working on feeding issues. She has...
The patient is a 5-week-old baby girl with a prenatal diagnosis of hypoplastic left heart syndrome, status post-Norwood with a 3.5mm BTT shunt at DOL5....
Chest Pain
Children's NationalIn this scenario, you are called to evaluate an adolescent in the Emergency Department for severe chest/epigastric pain, headache, and emesis. The patient is a 15-year-old previously healthy male who developed fever, nasal congestion, rhinorrhea, cough, and malaise 1 week ago. He was seen by his PMD and started on...
In this scenario, you are called to evaluate an adolescent in the Emergency Department for severe chest/epigastric pain, headache, and emesis. The patient is a...
Coarctation
Children's National2-week-old baby girl otherwise healthy, born at 38 weeks presenting with respiratory distress. Her parents have noted that she has been breathing faster and feeding less. She has an older brother (3-year-old who is in daycare). Symptoms have been getting worse over the last couple days. She was seen at...
2-week-old baby girl otherwise healthy, born at 38 weeks presenting with respiratory distress. Her parents have noted that she has been breathing faster and feeding...
Desaturation & Bradycardia
Children's NationalIn this scenario the patient is a 2-month-old ex-full-term male with a history of a small secundum ASD and moderate conoventricular septal defect. He is POD#0 from stitch closure of ASD and patch repair of the VSD. The post-op TEE shows a small residual ASD, no residual VSD, and good...
In this scenario the patient is a 2-month-old ex-full-term male with a history of a small secundum ASD and moderate conoventricular septal defect. He is...
Intubation of Suspected COVID Patient
Children's NationalIn this scenario, a patient with a history of repaired congenital heart disease arrives at the CICU in respiratory distress. This case is progressing to respiratory failure and the patient requires immediate intubation. Learners will start outside the room and receive pre-arrival information of impending respiratory failure. The learner must...
In this scenario, a patient with a history of repaired congenital heart disease arrives at the CICU in respiratory distress. This case is progressing to...
Low Cardiac Output Syndrome
Children's NationalA 3 month-old infant s/p complete AV canal defect repair is recovering in the first postoperative night in the cardiac intensive care unit. He develops junctional ectopic tachycardia with a narrow pulse pressure and hypotension. Learners must recognize and diagnose the arrhythmia and provide therapies to improve the cardiac output...
A 3 month-old infant s/p complete AV canal defect repair is recovering in the first postoperative night in the cardiac intensive care unit. He develops...
Post-Op SVT
Children's NationalIn this scenario, a 7-day old infant is in the cardiac intensive care unit recovering from a coarctation repair. The patient is intubated with all postoperative lines, drains, etc. and is in hemodynamically unstable supraventricular tachycardia at the beginning of the scenario. The patient has already been given adenosine twice...
In this scenario, a 7-day old infant is in the cardiac intensive care unit recovering from a coarctation repair. The patient is intubated with all...
Post-Op: Hypoxia & Hypotension
Children's NationalIn this scenario the patient is a 4 d/o male with HLHS (mitral and aortic atresia) s/p Stage 1 (Norwood) procedure presenting in a low-output state with progressive hypotension and hypoxemia. Learners must assess the patient, evaluate the situation, recognize abnormal findings, and respond with appropriate interventions.
In this scenario the patient is a 4 d/o male with HLHS (mitral and aortic atresia) s/p Stage 1 (Norwood) procedure presenting in a low-output...
Pulmonary Hypertensive Crisis
Children's NationalIn this scenario, the patient is a 3-day-old male with a history of obstructed supracardiac TAPVR. He progressively develops a pulmonary hypertensive crisis with decreasing oxygen saturation, elevated heart rate, and decreasing blood pressure. The learner must recognize that the patient is at high risk for a pulmonary hypertensive crisis...
In this scenario, the patient is a 3-day-old male with a history of obstructed supracardiac TAPVR. He progressively develops a pulmonary hypertensive crisis with decreasing...
Tetralogy of Fallot with Hypercyanotic Spell
Children's NationalThe patient is a 2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. An IV was placed when the patient was in the triage area and the saturations since the arrival to the ED have been in the 60s. This scenario begins with a notably cyanotic infant with...
The patient is a 2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. An IV was placed when the patient was in the...