CONGENITAL HEART DISEASE
• A congenital heart defect (CHD), also known
as a congenital heart anomaly and congenital
heart disease, is a defect in the structure of
the heart or great vessels that is present at
birth.
CAUSES
• 85-90% of cases, there is no identifiable cause
for the heart defect generally considered to be
caused by multifactorial inheritance
• Factors are usually both genetic and
environmental
Contd….
• MATERNAL FACTORS
Seizures disorders
Intake of lithum for depression
Uncontrolled IDDM
German measles(rubella) 1st trimester of
pregnancy.
CONTD….
• FAMILY HISTORY
Parents have congenital heart defect
One child with CHD than there will be 1.5 to
5% of chances that another child having CHD
If mother have CHD the risk of child having
CHD ranges from 2.5to 18%
Contd….
• CHROMOSOME ABNORMALITIES
5-8% of all babies with CHD have a
chromosome abnormalities
Including downs syndrome, trisomy 18 and
trisomy 13 , turner’s syndrome.
COARCTATION OF AORTA
• Coarctation of the aorta also called aortic
narrowing, is a congenital condition whereby
the aorta is narrow, usually in the area where
the ductus arteriosus (ligamentum arteriosum
after regression) inserts. The word coarctation
means "pressing or drawing together;
narrowing".
Types
• There are three types of aortic coarctations:
• Preductal coarctation: The narrowing is proximal to the
ductus arteriosus. Blood flow to the aorta that is distal to
the narrowing is dependent on the ductus arteriosus;
therefore severe coarctation can be life-threatening.
Preductal coarctation results when an intracardiac anomaly
during fetal life decreases blood flow through the left side
of the heart, leading to hypoplastic development of the
aorta. This is the type seen in approximately 5% of infants
with Turner syndrome.[4][5]
Types contd
• Ductal coarctation: The narrowing occurs at
the insertion of the ductus arteriosus. This
kind usually appears when the ductus
arteriosus closes.
TYPES CONTD…..
• Postductal coarctation: The narrowing is distal to the
insertion of the ductus arteriosus. Even with an open
ductus arteriosus, blood flow to the lower body can be
impaired. This type is most common in adults. It is
associated with notching of the ribs (because of collateral
circulation), hypertension in the upper extremities, and
weak pulses in the lower extremities. Postductal
coarctation is most likely the result of the extension of a
muscular artery (ductus arteriosus) into an elastic artery
(aorta) during fetal life, where the contraction and
fibrosis of the ductus arteriosus upon birth subsequently
narrows the aortic lumen.
Clinical manifestation
• Coarctation of the aorta symptoms depend on
the severity of the condition. Most people
don't have symptoms. Children with serious
aortic narrowing may show signs and
symptoms earlier in life, but mild cases with
no symptoms might not be diagnosed until
adulthood. People may also have signs or
symptoms of other heart defects that they
have along with coarctation of the aorta
• Babies with severe coarctation of the aorta may
begin having signs and symptoms shortly after
birth. These include:
• Pale skin
• Irritability
• Heavy sweating
• Difficulty breathing
• Difficulty feeding
• Left untreated, aortic coarctation in babies might lead to heart
failure or death.
• Older children and adults with coarctation of the aorta often don't
have symptoms because their narrowing may be less severe. If
you have signs or symptoms that appear after infancy, will have
high blood pressure (hypertension) . However, blood pressure is
likely to be lower in your legs. Signs and symptoms might include:
• High blood pressure
• Headache
• Muscle weakness
• Leg cramps or cold feet
• Nosebleeds
• Chest pain
Diagnostic test
• History taking
• Physical examination
• Electrocardiography
• Chest radiography
• Echocardiography
• Cardiac catheterization
MANAGEMENT
• Nonsurgical – balloon angioplasty
• Surgical
