Cardiovascular Glossary

Medications, Tests, & Terms


Medications

Terms


Aspirin

What Is Aspirin?

Aspirin is a medication that helps prevent blood clots from forming in children with congenital heart disease.

Side Effects:

Mild stomach upset and nosebleeds

Special Precautions:

  • Give with food to prevent stomach upset.
  • Be sure that all doctors and dentists your child visits know that he/she is receiving aspirin.
  • Stop taking aspirin one week before surgery or cardiac catheterization. This is enough time for the blood clotting system to get back to normal.
  • If you forget to give a dose, do so as soon as you remember. If it is almost time for the next dose, wait until then to give the medicine, and skip the missed dose. Do not give an extra amount of medicine to make up for the missed dose.
  • Do not give Aspirin if you suspect your child has caught the flu.

General Precautions:

  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms:
    • More than mild bruising
    • Bloody or black stools
    • Prolonged nosebleed

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Captopril (Capoten)


What Is Captopril?

Captopril is a medication that decreases the workload of the heart by lowering the pressure in the blood vessels that the heart has to pump against.

Side Effects:

Persistent cough, increased sensitivity to the sun and low blood pressure

Special Precautions:

  • Store in refrigerator
  • Your child will take this medication two to three times a day as instructed by your cardiologist.
  • The liquid form of Captopril is not available in most drug stores. LLUMC outpatient pharmacy will specially prepare the liquid Captopril for your child.
  • Check your supply of Captopril before weekends, holidays and vacations or other times when it may be difficult to obtain a refill.
  • If you forget to give a dose, do so as soon as you remember. If it is almost time for the next dose, wait until then to give the medicine, and skip the missed dose. Do not give an extra amount of medicine to make up for the missed dose.
  • If your child has vomiting, diarrhea or is unable to take liquids, do not give scheduled Captopril. Restart Captopril when your child is tolerating liquids.
  • Captopril causes the skin to become easily sunburned. Make sure your child uses sun block when outdoors.

General Precautions:

  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms:
    • Dizziness, fainting, fast or pounding heartbeat
    • Persistent dry cough

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Cardiac Catheterization

What Is It?

A cardiac catheterization is a specialized procedure in which a long, flexible tube (catheter) is inserted into a vein or artery and guided into the heart, allowing a closer look at the structures inside. The procedure takes 2-3 hours. There are several reasons to have a cardiac catheterization:

  1. To better define your child's heart problem
  2. To determine how well your child's heart is working
  3. To prepare for surgery
  4. In some instances, to fix the heart problem in the cardiac catheterization laboratory
Before Catheterization

Prior to catheterization your child will be scheduled for a pre-cath visit. During this visit your child's height, weight and vital signs will be checked along with a doctor's physical exam. This is a good time for you to inform the doctor of any medications that your child is taking, or if your child has had any recent illness or fever. In some instances, your doctor may decide to stop the medications a day before the cath procedure, or the cath may need to be rescheduled for a time when your child is well. If your child is taking Coumadin please stop the medication 3 days before the procedure. If your child is taking Aspirin please stop the medication 2 days before the procedure. Please hold all other medications the morning of the procedure.

The Day of the Catheterization

Your child will be admitted to the pediatric observation area (Unit 2800) two to three hours before the cardiac catheterization is scheduled. In order to safely administer sedation/anesthesia, it is important to follow these special diet instructions and give nothing after theses times indicated:

  1. Infants 0-12 months:
    A. Solids until 8 hours before the procedure
    B. Infant formula until 6 hours before the procedure
    C. Breast milk until 4 hours before the procedure
    D. Clear liquids (water, apple juice) until 2 hours before the procedure
  2. Children older than 1 year of age:
    A. Solid food until 8 hours before the procedure
    B. Full liquids until 6 hours before the procedure
What Your Child Can Expect

In the pediatric observation area (Unit 2800), your child will change into a hospital gown. You may stay with your child until he or she is taken in for the procedure. A nurse will start an IV and take a small amount of blood. Your child will get medicine to make them sleepy and relaxed 15 to 30 minutes before the heart cath. During the procedure, the doctor will give medications and fluids through the IV. Ask the nurse about EMLA, a numbing cream, which can make starting an IV less painful for your child. The EMLA cream takes about 30 minutes to work.

The Heart Catheterization Procedure

In a heart catheterization specialized tubes are placed in the groin area (where the legs meet the body) to allow the doctor to get special catheters through large vessels into the heart. In some instances, the doctor may use the neck veins. With sedation, a numbing medication is used prior to placement of these tubes. The doctor watches the movement of these catheters under x-ray guidance on a TV monitor in the cath lab. The x-ray or fluoroscopy is a very low dose x-ray. It takes several minutes of fluoroscopy to equal the power of a regular chest x-ray. Through the catheter, pressures are measured and samples of blood are drawn from various areas within the heart. Contrast (x-ray dye) is injected through the catheters to get a clear picture of the internal heart structure.

After Catheterization

When your child arrives in the recovery area, a nurse will monitor them closely. Your child will be sleepy for the next few hours. It is important for them to lie flat on their back to prevent bleeding at the catheterization site. The elastic bandage will remain in place for five hours, and then be removed.

For times when the doctor does a special procedure, your child may be admitted to the hospital for overnight observation. The bandages will then stay on all night. Your child will be required to lay flat for six hours.

An IV will be in place and continue to run until your child shows they can tolerate drinking fluids. Small amounts of liquids are offered initially. Prior to discharge the IV will be removed.

You will meet with the cardiologist after the catheterization to discuss the results of the test. Any questions you have can be answered at this time. In some instances a more complete review of the information is needed. For these cases, the information is presented at the joint Cardio-Surgical conference, which is attended by all cardiac team members. Final plans regarding the management of your child will be discussed with you after this meeting by your referring cardiologist.

Discharge

For most catheterization, patients can be discharged late in the afternoon or early evening. In some instances, your child may be required to stay in the hospital overnight. Your doctor will make the decision when your child can go home.

Prior to going home, the pressure dressing is removed from your child's catheterization site. This site should be kept clean and dry. A Band-Aid should be placed over the site for five days. Each day change the Band-Aid and observe the site for pus-like drainage, redness, swelling, tenderness, or increased bruising. Do not disturb the scab that forms. Your child may shower, but there are no tub baths or swimming until the scab falls off (7-10 days).

Bruising and mild discomfort at the catheterization site is expected. Tylenol or Advil may be given for discomfort. Bleeding, swelling, severe discomfort or significant pain upon walking should be called to the doctor's attention.

Rest is important the day of the cath. The day following the cath, there are no restrictions for infants or toddlers. Children and adolescents should not take part in rough play or contact sports for 7 days. Regular daily activities are permitted.

 

Coumadin (Warfarin)

What is Coumadin

Coumadin is a "blood thinner" or an anticoagulant. It decreases the clotting ability of the blood. This helps prevent harmful clots from forming in the blood vessels or on mechanical heart valves.

Side Effects:

Excessive bleeding

Special Precautions:
  • Give this medicine only in the amount your doctor orders.
  • If you miss a dose, give it as soon as possible, if you remember the same day. Then go back to the regular schedule. If you can't remember if you gave the dose, do not give it. It is safer to miss one dose than to take an extra dose.
  • Your child will need to have regular blood test to check the level of Coumadin in the blood. The test that is used is known as PT/INR. This number is watched closely so that your child will receive the right amount. Minimum frequency of testing will be once per month.
  • Be sure that all doctors and dentists your child visits know that he/she is receiving Coumadin.
  • Do not give any other medication, such as aspirin, ibuprofen, antihistamine or antibiotics, unless you check with your doctor first.
  • Normal childhood play such as recess and gym are safe. Avoid contact sports.
  • Always make sure your child wears a helmet when riding bikes, roller blading or skate boarding.
  • If your child falls or becomes injured, and has bleeding, pain, swelling, excessive bruising or a change in their level of consciousness, call your doctor and go to the nearest emergency room.

Interactions of Coumadin with Food/Medications:

  • Vitamin K affects how Coumadin works on the clotting factors and is in many foods and multi-vitamin supplements. If your child likes to eat vegetables containing Vitamin K, then the Coumadin does will have to be adjusted. Foods rich in vitamin K are: broccoli, brussel sprouts, liver (beef or pork), cauliflower, spinach and lettuce.
  • Many drugs interact with Coumadin. Contact your cardiologist if you add or stop any medications.
Other Things That May Affect How Coumadin Works:
  • Fever (greater than 101 for 24 hours)
  • Diarrhea, vomiting
  • Use of antibiotics

Notify your doctor if these occur. They may cause your child to bleed more easily.

General Precautions:
  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.
When Should You Call The Cardiologist?
  • Call the cardiologist if your child has any of the following symptoms:
    • Heavy bleeding from a small cut
    • Bleeding from gums when brushing teeth
    • Unexplained bruising or purplish areas on the skin
    • Unexplained nosebleeds
    • Red or black stools
    • Bloody or tea colored urine
    • Vomiting or coughing up of blood or coffee ground material
    • Severe headaches
    • Unusually heavy or unexpected menstrual bleeding
    • Joint pain

Never ignore signs of bleeding. If you have questions or concerns, contact the cardiologist at (909) 558-4711. At night or on weekends call the paging operator (909) 558-4000 and ask for the pediatric cardiologist on call.

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Digoxin (Lanoxin)

What Is Digoxin?

Digoxin is a medicine that slows down the heartbeat and makes the heart pump stronger and more regularly.

Side Effects:

Irregular heart rate, nausea, vomiting and loss of appetite

Special Precautions:
  • Store in refrigerator
  • Avoid "hiding" or "disguising" Digoxin by mixing it with your child's food or bottle. This makes it impossible to tell how much medicine your child has taken if only some of the meal is eaten.
  • If your child vomits a large amount within five minutes of receiving Digoxin, repeat the dose. If more than five minutes have passed do not give any more. Give the next dose at the regular time.
  • If you forget to give a dose, do so as soon as you remember. If more than six hours have passed since the dose was supposed to have been given, skip the dose completely and give the next dose at the regular time. Do not give an extra amount of medicine to make up for the missed dose.
  • In the event of an overdose or accidental ingestion of Digoxin, take your child to the nearest emergency room. Bring the Digoxin bottle with the remaining medicine with you.
General Precautions:
  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms:
    • Decrease in activity or increased sleeping or drowsiness
    • Slow or irregular heartbeat

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Inderal (Propranolol)

What Is Inderal?

Inderal is in a class of drugs called beta-blockers. Inderal slows down the heart rate and is used to reduce high blood pressure and treat irregular or fast heartbeats.

Side Effects:

Fatigue, low blood pressure, dizziness and sleeping problems

Special Precautions:
  • Take Inderal exactly as directed by your cardiologist.
  • Inderal can be taken with or without food.
  • Avoid "hiding" or "disguising" Inderal by mixing it with your child's food or bottle. This makes it impossible to tell how much your child has taken if only part of the meal is eaten.
  • Give Inderal at the same times each day. If you miss a dose, wait until the next scheduled time to take the dose. If your child spits up a dose, do not give another dose, wait until the next scheduled medication time.
  • Do not stop taking Inderal until talking to your cardiologist.
  • Inderal should be given with caution if your child has Asthma or Diabetes. Please inform your cardiologist if your child has one of these conditions.
General Precautions:
  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms:
    • Decrease in activity or increased sleeping or drowsiness
    • Slow heart rate

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Lasix (Furosemide)

What Is Lasix?

Lasix is a medication that removes extra fluid from the body by increasing urination.

Side Effects:

Frequent urination, upset stomach, increased skin sensitivity to the sun, low blood pressure and dry skin

Special Precautions:
  • Lasix lowers the potassium level in the body because of potassium loss in the urine. Encourage foods high in potassium such as bananas, oranges, grapefruit, raisins, yogurt, wheat germ and apricot juice.
  • Children taking lasix and other diuretics can become easily dehydrated if they have diarrhea or vomiting that last more than 24 hours. Signs of dehydration in children include decreased urine output, dry mouth, lack of tears with crying and dry skin. If your child has any of these symptoms, please call your child's pediatrician right away.
  • If your child has vomiting, diarrhea or is unable to take liquids, do not give scheduled Lasix because your child can become dehydrated. Restart Lasix when your child is tolerating liquids.
  • If you forget to give a dose, do so as soon as you remember. If it is almost time for the next dose, wait until then to give the medicine, and skip the missed dose. Do not give an extra amount of medicine to make up for the missed dose.
  • If this medicine upsets your child's stomach, it may be taken with meals or milk.
  • Because Lasix increases the number of times a child must urinate, children may prefer to take this medicine a couple of hours before bedtime so that their sleep is not disturbed.
General Precautions:
  • Keep all drugs locked in a safe area away from children's reach. It may be stored at room temperature.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.
When Should You Call The Cardiologist?
  • Call the cardiologist if your child has any of the following symptoms:
    • Dry mouth and increased thirst
    • Unusual tiredness, weakness, lightheadedness, or fainting

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Sedated Echocardiogram (ECHO)

What Is An Echo?

An echocardiogram (echo) is a test that uses ultrasound to get pictures of your child's heart. Having an echo is safe and painless. It is not a x-ray and there is no risk or danger to your child. You can stay with your child during the entire test which usually lasts 30 minutes to an hour.

The Day Of The Echo

Your child will be admitted to the pediatric observation area (Unit 2800) before the echo is scheduled. The echo technician will need to see your child's chest from the waist up so your child will change into a hospital gown. The room will be dark so the technician can view the images on the echo monitor. The technician will place gel on your child's chest. The probe (called a transducer) rests lightly on the gel and is moved around to take pictures of your child's heart from different angles. All pictures are recorded for a cardiologist to review.

What Preparation Is Needed For The Test?

To get the best results from this test, your child must be quiet and lie still during the echo. Many children three years and younger find it hard to lie still for the test, even though it doesn't hurt. These children may need to take a mild sedative called chloral hydrate to help them sleep during the echo. Chloral hydrate is a safe medication. It is given either my mouth or by suppository. The most common side effects can be an upset stomach and diarrhea. A nurse will monitor your child during the procedure if chloral hydrate is administered. In order to safely administer this medication, it is important to follow these special diet instructions, giving nothing after times indicated:

  1. Solids/whole milk until 8 hours before the procedure
  2. Infant formula until 6 hours before the procedure
  3. Breast milk until 4 hours before the procedure
  4. Clear Liquids such as apple juice, water or Pedialyte until 2 hours before the procedure

Do not bring other children the day of the test. After the test, your child will be sleepy. When they awake they will be given clear liquids. Remember to bring a stroller if necessary.

How Will I Get The Results Of The Test?

The doctor who ordered the echo will give the results of the test to you. The echo technician performing the test is not allowed to give you the results.If your child has fever, cough, or congestion please call (909) 558-8203 and reschedule for a time when your child is well.

 

Spironolactone (Aldactone)

What Is Spironolactone?

Spironolactone is a diuretic that removes a small amount of extra fluid from the body by increasing urination. Spironolactone helps the body hold on to potassium, an important electrolyte in the body. This medication may be given along with Lasix, another medication that increases urination, to help keep a normal potassium level.

Side Effects:

Frequent urination and upset stomach

Special Precautions:

  • Store in refrigerator
  • If this medicine upsets your child's stomach, it may be taken with meals or milk.
  • If you forget to give a dose, do so as soon as you remember. If it is almost time for the next dose, wait until then to give the medicine, and skip the missed dose. Do not give an extra amount of medicine to make up for the missed dose.
  • Children taking Aldactone and other diuretics can become easily dehydrated if they have diarrhea or vomiting that last more than 24 hours. Signs of dehydration in children include decreased urine output, dry mouth, lack of tears with crying and dry skin. Please call your child's pediatrician right away.
  • If your child has vomiting, diarrhea or is unable to take liquids, do not give scheduled Spironolactone. Restart Spironolactone when your child is tolerating liquids.

General Precautions:

  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms:
    • Dry mouth and increased thirst
    • Unusual tiredness, weakness, lightheadedness, or fainting

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.

 

Viagra (Sildenafil)

What Is Viagra?

Viagra is a medication used to lower the blood pressures in the lungs. This medication is used to treat pulmonary hypertension. Pulmonary hypertension occurs when the blood pressure in the lung vessels becomes higher than normal. When there is high blood pressure in the lungs, the right side of the heart has to work harder. If pulmonary hypertension is not treated, it can lead to permanent damage to both the heart and lungs.

Side Effects:

Headache, flushing and dizziness

Special Precautions:

  • The pediatric dose of Viagra is not available in most drug stores. LLUMC outpatient pharmacy will specially prepare the liquid Viagra for your child.
  • Check your supply of Viagra before weekends, holidays and vacations or other times when it may be difficult to obtain a refill.
  • If you forget to give a dose, do so as soon as you remember. If it is almost time for the next dose, wait until then to give the medicine, and skip the missed dose. Do not give an extra amount of medicine to make up for the missed dose.
  • Viagra should not be administered at the same time as diuretics such as Lasix (Furosemide) or blood pressure medications such as Captopril (Capoten).

General Precautions:

  • Keep all drugs locked in a safe area away from children's reach.
  • Give medicine only as your doctor has ordered it-the exact amount and on a set schedule.
  • Always check the expiration date on the bottle of medicine.
  • Your child should be followed closely by the doctor while on this medicine.
  • Keep medications in original containers.

When Should You Call The Cardiologist?

  • Call the cardiologist if your child has any of the following symptoms repeatedly after the dose:
    • Upset stomach, headache or dizziness

Ask your child's doctor before giving any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Please bring your child's medications to all clinic appointments.

If you have any questions or concerns, please call us at (909) 558-8138.