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Congenital Heart Disease

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Presentation on theme: "Congenital Heart Disease"— Presentation transcript:

1 Congenital Heart Disease

2 congenital heart disease can be organized into three major categories:
Malformations causing a left-to-right shunt Malformations causing a right-to-left shunt Malformations causing an obstruction A shunt is an abnormal communication between chambers or blood vessels

3 pulmonary/venous ---- Systemic/arterial
right-to-left shunt: pulmonary/venous ---- Systemic/arterial Deoxygenated Oxygenated --- cyanosis Hypoxia clubbing (hypertrophic osteoarthropathy) paradoxical embolism

4 left-to-right shunt: Systemic/arterial ---- pulmonary/venous Oxygenated deoxygenated--- no cyanosis right ventricular hypertrophy Pulmonary congestion hypertension Rt-to-left shunt (Eisenmenger syndrome)--- cyanosis

5 left-to-right shunt: - m.C - ASD, VSD (m.c) , PDA, AVSD

6 right-to-left shunt: Tetralogy of Fallot m.c Transposition of the Great Arteries persistent truncus arteriosus Tricuspid atresia total anomalous pulmonary venous connection

7 Obstructive Lesions: aortic or pulmonary valve stenosis or atresia coarctation of the aorta subpulmonary stenosis in TOF

8 ASD Defect in septum primum or secundum
Mortality is low, and long-term survival is comparable to that of the normal population. Asymptomatic until adulthood


10 Patent Foramen Ovale foramen ovale/ostium secundum permits continued right-to-left shunting of blood during intrauterine development. the unsealed flap can open if right-sided pressures become elevated (coughing, /sneezing) can produce brief periods of right-to-left shunting

11 Ventricular Septal Defect
Membranous (m.c), muscular, infundibular The functional consequences of a VSD depend on the size


13 Patent Ductus Arteriosus
ductus arteriosus---pulmonary artery---aorta During intrauterine life, it permits blood flow from the pulmonary artery to the aorta, thereby bypassing the unoxygenated lungs. + prostaglandin, immuture Used to save life in pulmonary or oartic valve obstruction or atresia


15 atrioventricular (AV) septal defect
Endocardial cushion defect Down syndrome


17 Tetralogy of Fallot VSD (2) subpulmonary stenosis/infundibulum
(3) an aorta that overrides the VSD (4) Right ventricular hypertrophy


19 Transposition of the Great Arteries
Aorta---anterior---right ventricle pulmonary artery---posterior---left ventricle Parallel instead of series incompatible with postnatal life unless a shunt exists for adequate mixing of blood.


21 persistent truncus arteriosus
failure of separation of truncus into aorta and pulmonic trunck . The truncus overrides both ventricles. Always accompanied by a membranous VSD.


23 total anomalous pulmonary venous return (TAPVR)
pulmonary veins----innominate vein/coronary sinus Patent foramen ovale/ or ASD always present


25 Coarctation of the Aorta
Narrowing 2 types 1- infantile: + PDA---- early after birth--- cyanosis in lower ½ of body 2- adult: - PDA---- late presentation---- HTN in upper extremities


27 Aortic Stenosis and Atresia
Valvular--- hypoplastic left heart syndrome Supravalvular Subvalvular----- sudden death with exertion



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