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    Congenital Heart Disease

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    Raja
    1. Congenital heart disease can be caused by genetic factors, maternal conditions like rubella, or environmental exposures. 2. CHDs are classified as cyanotic or acyanotic depending on blood flow and oxygen saturation. Common acyanotic defects include atrial and ventricular septal defects and patent ductus arteriosus which cause left to right shunts. 3. Clinical features, investigations, and treatments vary depending on the specific defect but may include murmurs, enlarged hearts, pulmonary hypertension, and surgical closure.

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    Congenital Heart Disease

    Uploaded by

    Raja
    8K views13 pages
    1. Congenital heart disease can be caused by genetic factors, maternal conditions like rubella, or environmental exposures. 2. CHDs are classified as cyanotic or acyanotic depending on blood flow and oxygen saturation. Common acyanotic defects include atrial and ventricular septal defects and patent ductus arteriosus which cause left to right shunts. 3. Clinical features, investigations, and treatments vary depending on the specific defect but may include murmurs, enlarged hearts, pulmonary hypertension, and surgical closure.

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    1. Congenital heart disease can be caused by genetic factors, maternal conditions like rubella, or environmental exposures. 2. CHDs are classified as cyanotic or acyanotic depending on blood flow and oxygen saturation. Common acyanotic defects include atrial and ventricular septal defects and patent ductus arteriosus which cause left to right shunts. 3. Clinical features, investigations, and treatments vary depending on the specific defect but may include murmurs, enlarged hearts, pulmonary hypertension, and surgical closure.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    8K views13 pages

    Congenital Heart Disease

    Uploaded by

    Raja
    1. Congenital heart disease can be caused by genetic factors, maternal conditions like rubella, or environmental exposures. 2. CHDs are classified as cyanotic or acyanotic depending on blood flow and oxygen saturation. Common acyanotic defects include atrial and ventricular septal defects and patent ductus arteriosus which cause left to right shunts. 3. Clinical features, investigations, and treatments vary depending on the specific defect but may include murmurs, enlarged hearts, pulmonary hypertension, and surgical closure.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 13

    CONGENITAL HEART DISEASE

    Etiology of Congenital Heart Diseases (CHD):

    The etiology of most CHD is unknown, but


    several factors are associated with a higher
    than normal incidence. These include:
    1- Maternal rubella during pregnancy.
    2. Maternal alcoholism. Age over 40 years
    and insulin dependant diabetes.
    3. Several genetic factors.
    4. Exposure to radiation.
    Epidemiology

    • Prevalence:0.5-0.8% of live births


    (8/1000).Leading cause ofdeath in children with
    CHD.

    • Etiology:Unknown,multifactorial
    inheritance,genetic factors implicated,high
    incidence in first degree relatives.
    • 3% have a single gene defect,13% have
    associated chromosomal abnormalities.
    • 2-4% are associated with environmental or
    maternal conditions & teratogenic
    influences.
    • Gender differences:ASD,VSD,PDA &
    Pulmonic stenosis more common in
    girls,left sided lesions in boys.
    Classification

    • Acyanotic:according to • Cyanotic:based on
    the predominant pathophysiology.
    physiologic load placed
    on the heart. • Decreased pulmonary
    bloodflow:TOF,Pulmona
    • Volume load:L-R
    shunts-ASD,VSD,PDA. ry atresia,Tricuspid
    atresia,Single ventricle
    • Pressure
    load:Ventricular outflow with pulmonic stenosis.
    obstruction • Increased pulmonary
    • Pulmonary,aortic valve blood flow:Transposition
    lesions,aortic of great
    coarctation & vessels,Truncus
    pulmonary stenosis. arteriosus.
    ATRIAL SEPTAL DEFECT.

    Abnormal opening between


    the atria, allowing blood
    from -the higher pressure -
    left atrium to flow to -the
    lower pressure- right atrium.
    The resulting left to right
    shunting of blood which
    place a burden on the right
    side of the heart resulting in
    an increased blood flow.
    ATRIAL SEPTAL DEFECT.
    • Sinus venosus defect:high in the septum.
    • Ostium secundum defect:midseptum.
    • Ostium primum defect:low in the septum.
    • Pathophysiology:L-R shunt-increased flow
    across Rt heart-RV & PA enlargement.
    • Clinical features:asymptomatic,slow wt
    gain,frequent LRTI.
    • Diagnosis:Rt ventricular heave,systolic
    murmur,fixed wide split S2.
    Investigations:

    • CXR:enlarged heart & PA,increased


    vascularity.
    • ECG:Rt axis in secundum defect,hallmark
    of primum defect is extreme Lt axis,RVH.
    • ECHO:RVH,valve anatomy,flow direction.
    • Treatment:closure during cardiac
    cathetrization,surgical closure.
    VENTRICULAR SEPTAL DEFECT.
    • Most common CHD (26%),may be single or
    multiple.
    • Pathophysiology:Lt-Rt shunt as long as
    pulmonary vascular resistance is lower than
    systemic resistance,if reverse shunt reverses
    • Large defects lead to pul.hypertension-
    Eissenmenger syndrome.
    • Clinical features: depend on
    size,asymptomatic,growth failure,recurrent
    LRTI,congestive heart failure,SOB,cyanosis
    • Diagnosis:pansystolic murmur,loud p2.
    Investigations
    • CXR:cardiomegaly,enlarged LA&LV.
    • ECG:extreme lt axis is
    charecteristic,biventricular hypertrophy.
    • ECHO:chamber size & pressures.
    • Cardiac catheter:O2 content,PA pressure,size &
    no of defects.
    • Treatment:Endocarditis
    prophylaxis,digoxin,diuretics.
    • Surgical closure before pulmonary vascular
    changes become irreversible.
    PATENT DUCTUS ARTERIOSUS.
    • Connection between PA & descending aorta
    • 10% of CHD.
    • Pathophysiology:Lt-Rt shunt,reverses if
    pulmonary resistance increases-RV
    enlargement.If PDA is large Eissenmenger
    syndrome can develop.
    • Clinical features:depend on size & direction of
    flow,slow growth,LRTI,SOB,cyanosis.
    • Diagnosis:bounding pulse,continous
    murmur,loud S2.
    Investigations :
    • CXR:cardiomegaly,increased pul vascularity.
    • ECG:Lt or biventricular hypertrophy.
    • ECHO:2D visualises PDA,doppler shows
    turbulance.
    • Cardiac catheter:PA pressures & O2 sats.
    • Treatment:Endocardial prophylaxis as long as
    patent,Indomethacin.
    • Surgical:ligation is curative.

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