Congenital Heart
Disease
1. Classification of Congenital Heart
Disease.
2. A cyanotic Heart Disease
a. Increase pulmonary blood flow
b. Obstruction of blood flow
3. Cyanotic Heart disease
a. Decrease pulmonary blood flow
b. Mixed blood flow .
A Cyanotic Heart Defect
Move blood from arterial …to…venous system
A Cyanotic
Increased in pulmonary
Obstruction of blood flow form
blood flow
ventricle
1. ASD
1. Pulmonary stenosis
2. VSD
2. Aortic stenosis
3. AVC
3.Coarctation of the Aorta
4. PDA
Defect with increased
pulmonary blood flow
1. VSD (ventricular septal defect )
2. ASD (Atrial septal defect )
3. AVC (Atrioventricular canal defect
)
4. PDA ( patent ductus arteriosus)
VSD (ventricular septal defect )
VSD …30% of CHD
85% spontaneous closed
*Assessment . (4 to 8 week of age ) fatigue…
murmur…thrill may be palpable..
Echo .ECG, MRI ,(RT ventricle hypertrophy )
Treatment …
cardiac catheterization .. Surgery
ASD (blood flow from left to right
atrium)
Tow type ..
1. Ostium primum ( lower end of the septum )
2. Ostium secundum( center of the septum )
**Assessment ...systolic murmur
enlarged RT side of the heart ..increased in pulmonary
circulation…Echo.
**Management …cath repaired, or open heart surgery
(1 to 3 years)
**Complication ..arrhythmias …emboli
AVC ( Atrioventricular Canal
Defect)
Low a trial septal defect continuous with high
ventricular defect and distortion of the mitral
and tricuspid valve
**Assessment …Echo …surgical is important
some time need new valve
**Treatment …after surgery give antibiotic and
anticoagulant
Closed observation to the jaundice
PDA ( Patent Ductus
Arteriosus)
it’s failed to closed at birth ,blood will shunt
from the aorta to the pulmonary artery.
Complete closure occurs…3 month
More common in girls than boys
**Assessment ….direct after cardiac
catheterization
**Treatment…in infant give IV or OR
indomethacin(3time \12hr or 24hr)
to lead to closed the ductus
Side effect…
1.reduce glomerular filtration rate.
2.Impaired plat aggregation
3.Demention GI&CNS blood flow
Treatment…
Cath at age of (6m to 1y) or surgical
intervention by Thoraoctomy
If not treatment …
1. CHF
2. Infected Endocardities
Obstruction of blood flow form
ventricle
1.Pulmonary stenosis
2.Aortic stenosis
3.Coarctation of the Aorta
pulmonary stenosis 10%
Narrowing in pulmonary valve
Assessment like RT side heart failure
Systolic murmur…thrill
ECG …Echo ( RT side hypertrophy )
Treatment
Balloon angioplasty
Aortic stenosis
7% of total cases of CHD
Increased pressure in the LF side of the heart
(LV hypertrophy)
Assessment… murmur ,thrill ,high BP, high
HR.
Treatment..
- Beta-blocker or ca channel blocker to
decreased hypertrophy
- Balloon valvoplasty
Coarctation of the Aorta 6%
in boys more than in girls
** assessment
high BP in upper body part in the arm
20mmhg more than leg, headache,
vertigo, epistaxis.
Treatment
Digoxin & diuretic
Surgical at the age of 2yrs
Cyanotic Heart Defect
Cyanotic
Decreased pulmonary
Mixed blood flow
blood flow
mixed blood flow
1. Transposition of the great Arteries
2. Total pulmonary venous return
3. Truncus Arteriosus
4. Hypo plastic left Heart Syndrome
Transposition of the great
Arteries
In boys more than girls
*assessment …cyanotic from birth,
murmur may or not ,Echo, cath.
*Treatment.
PGE to keep PDA opining
Surgical at 1week to 3months
Total Pulmonary venous
return 2%
Pulmonary vein return to the right atrium or the
superior vena cava instead of the left atrium
* Treatment
Give PGE, cath, and surgical treatment
Truncus Arteriosus 1%
One major artery or (trunk) arises from the LF
& RT ventricle in place of a separate Aorta &
Pulmonary Artery
with VSD.
Assessment … Cyanosis
Treatment … surgical at school age
Hypo plastic left Heart
Syndrome
*assessment of HLHS
Infants may appear healthy at birth, but signs
of HLHS soon become apparent after the
ductus arteriosus closes. These signs
include the following:
Cyanosis (a blue skin, lips, fingernails and
other areas of the body as a result of the lack
of oxygen-rich blood to the body)
1.Heart murmur
2.Enlargement of the heart (as seen in an
echocardiogram)
3.Noticeably troubled breathing
4.Apparent weakness
5.Inability to feed normally
6.Cold extremities
Defect with Decreased pulmonary
blood flow
1. Tricuspid Artesia
2. Tetrology of Fallot
Tricuspid Artesia
Tricuspid valve closed no blood from RA to
RV
*if foramen ovale and PDA still open will
maintain good O2 blood so you have to give
PGE IV.
If not sever cyanosis ,tachycardia ,
dyspnea
* Treatment
Surgically
Tetrology of Fallot 10%
1.pulmonary stenosis
2.VSD *usually large*
3.dextra position (overriding of the
Aorta )
4.hypertrophy of the right ventricle.
