1. Congenital Heart Disease
Dr. Raid Jastania

2. Congenital Heart Disease
8 per 1000 live birth
Could be minor defect or major defect
Cause – unknown
Genetic: chromosomal anomalies, trisomy 13, 18, 21
Environmental: infections, rubella
Types:
Left-to-Right shunt
Right-to-Left shunt
Obstructive defects

3. Left-to-Right Shunt

4. Left-to-Right Shunt Most common ASD, VSD, PDA
May be asymptomatic at birth
Cyanosis is not early feature

5. Atrial Septal Defect 75% ostium secondum ASD 15% ostium primum ASD
10% sinus venosus ASD

7. Atrial Septal Defect Diagnosed usually in adulthood
Left to right shunt
Right atrial dilatation, right ventricular hypertrophy
Pulmonary hypertension
Late: Cyanosis (Eisenmenger syndome)
CHF

9. Ventricular Septal Defect
70% in the membarneous region
Most common congenital heart disease
Many VSD close spontaneously
Left to right shunt
Right ventricular hypertrophy/dilatation
Dilated pulmonary artery
Pulmonary hypertension
Late: CHF, cyanosis

11. Patent ductus arteriosus

12. Patent ductus arteriosus
Ductus arteriosus closes after birth by
Increase arterial oxygen
Drop in pulmonary vascular resistance
Decrease in prostaglandin E2
PDA leads to Left to right shunt
Left atrial and left ventricular hypertrophy
Pulmonary hypertension – atherosclerosis and right ventricular hypertrophy
Machinery murmur
Late: Cyanosis, CHF

14. Right-to-Left shunt

15. Tetralogy of Fallot Most common cyanotic congenital heat disease
Consist of:
VSD
Over-riding Aorta
Pulmonary stenosis
Right ventricular hypertrophy
Boot shape heart
Right to left shunt
Pulmonary hypertension does not occur

17. Transposition of Great Arteries
Aorta from the right ventricle
Pulmonary artery from the left ventricle
+ PDA, ASD, VSD
Cyanosis

19. Obstructive Defect

20. Coarctation of Aorta Narrowing of the aorta Preductal coarctation
Before ductus arteriosus
Right ventricualr hypertrophy
Selective cyanosis of lower extremities
Postductal coarctation
Left ventricular hypertrophy
Hypertension of upper extremities
Weak pulse of legs