Ppt on eisenmenger syndrome asd

Heart disease with pregnancy Prof Uma Singh. Incidence of heart disease Varies between 0.1 – 4.0 %, average 1% Mortality due to heart disease has decreased.

defects, syphilitic, thyrotoxic, hypertensive, Classification of Heart Disease during pregnancy according to risk Low risk ( 0 – 1%) – ASD, VSD, PDA, MS- 1,2, corrected FT Medium risk ( 5 – 15 %) – MS-3,4, MS with atrial fibrillation, AS, uncorrected FT High risk ( 25 – 50%) – PH, Eisenmengers Syndrome, aortic coarctation with valvular involvement, Marfans with aortic involvement Poor prognostic indicators h/o heart failure, ischaemic/


Congenital Heart Disease and Cardiac Imaging Modalities

those with multiple defects, AV canal defects, or “single” ventricle physiology. Cyanotic or non-cyanotic Non-cyanotic: ASD, VSD, sinus venosus defect, patent ductus arteriosus, aortic stenosis, pulmonary stenosis, aortic coarctation Cyanotic: Tetralogy of Fallot, Ebstein’s anomaly, transposition of the great arteries, Eisenmenger’s syndrome, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous return “5 Ts and 2 Es” The heart is/


Internal Medicine Board Review Cardiology

percutaneously or surgically) for shunt > 1.5:1 No SBE prophylaxis recommended – low risk Atrial Septal Defect ASD EKG ASD TEE ASD Occluder VSD Scenario – asymptomatic young adult referred for murmur Diagnosis – loud grade 5/6 pansystolic murmur at LSB/ during surgery Pregnancy and Heart Disease High risk Eisenmenger’s syndrome Severe pulmonary HTN Severe aortic stenosis/LVOT obstruction Coarctation of the aorta with obstruction Marfan’s syndrome with aortic root > 43 mm Symptomatic systemic ventricular/


SECOND HEART SOUND Dr SHAJUDEEN .K DM Cardiology Resident

Wide splitting of S2 can happen if complete RBBB Paradoxical split occurs if Type B WPW association S2 in Anomalous pulmonary venous connection If Associated ASD : Wide fixed split If Atrial septum intact: S2 normal split with normal respiratory variation S2 in Eissenmenger syndrome ASD Eissenmenger syndrome: S2 narrow fixed split VSD Eisenmenger syndrome: Single Loud P2 PDA Eisenmenger syndrome: Closely split S2 with Loud P2 THANK U


Congenital heart diseases. These are abnormalities in the cardiocirculatory structures or function that are present at birth, even if it is discovered.

warferin, thalidomide, antimetabolites, anticonvulsants) classification Acyanotic CHD: a.Ventricular septal defects (VSD) 25% b.Atrial septal defects (ASD) 10% volvme c. Patent ductus arteriosus (PDA) 10% load Lf d. Pulmonary stenosis 10% e. Coarctation of the/the 1 st year of life, Without surgical repair, most patients will develop pulmonary hypertension and some reach to Eisenmenger syndrome (10%), but 5% wall develop infundibular & pulmonary stenosis. Those with supracristal VSD at risk for aortic /


CONGENITAL HEART DISEASES

crescentic shadow of vascular density along the right border of the cardiac silhouette Scimitar Syndrome Scimitar syndrome: ASD is not usually present but pulmonary sequestration and anomalous arterial supply to that lobe / Pulmonary hypertension and increased tendency to develop pulmonary vascular resistance  right to left shunting  cyanosis (Eisenmenger syndrome) AV valvular insufficiency Atrioventricular Septal Defects (AV Canal Defect) Clinical Manifestations Heart failure and intercurrent pulmonary /


ATRIAL SEPTAL DEFECT Dr. M. A. Sofi MD; FRCP (London); FRCPEdin; FRCSEdin.

for stroke due to paradoxical embolization (stroke, transient ischemic attack, or peripheral emboli). Migraine headache — Evidence is conflicting whether migraine is associated with right to left shunt via PFO or ASD Pulmonary hypertension and Eisenmenger syndrome — The development of pulmonary vascular injury is related to the degree and duration of right heart volume overload. Cyanosis — Cyanosis in patients with/


1 feb04 PEDIATRIC CARDIOLOGY Normal Heart RA RV LV LA ICV SCV PA AO.

location (less O2 ), metabolic disorders (DM) 5 Non cardiac malformation : 10 - 15% CHD (e.g. Cleft lips) Kartagener Syndrome (bronchiectasis, sinusitis paranasal, dextrocardia) AHD : - infection (RF, diphtheriae) - neonatus (Coxsackie B virus) 6 CONGENITAL HEART DISEASE (CHD/ on the size and pressure between RV and LV – –Pressure LV > RV  L-R shunt – –L-R, R-L (Eisenmenger S)  VSD, ASD – –Defect <<  small shunt – –Defect >>  large shunt – –Septum muscle contraction  diameter – –Other lesions 25 SIMPLE/


PHYSIOLOGICAL CHANGES IN PREGNANCY Dr. Sreejith V.

- Dilatation of the ascending aorta >45 mm, Severe aortic stenosis, Pre-term labor while on oral anticoagulants Eisenmenger syndrome, Severe OR worsening heart failure Mechanical prosthesis Labor Once in labor, the woman should be placed in a / regurgitation PAH Cyanosis Paradoxical embolization Offspring mortality due to the occurrence of complex congenital heart disease Ostium primum ASD may be well tolerated Pulmonary valve stenosis Relatively well tolerated if the right ventricular pressure is less than/


The Heart. Cardiac Structure and Specializations Myocardium Myocardium Valves Valves Conduction system Conduction system Blood supply Blood supply.

pressures reach systemic levels Pulm pressures reach systemic levels R to L shunt R to L shunt Eisenmenger Syndrome Eisenmenger Syndrome Altered hemodynamics of CHD Altered hemodynamics of CHD Dilation, hypetrophy or both Dilation, hypetrophy or both Decreased/ muscle mass – hypoplasia – before birth, atrophy – postnatally CHD L to R L to RASDVSDPDA AV septal defects CHD ASD ASD abnormal, fixed opening in the atrial septum usually asymptomatic until adulthood 3 types Secundum (90%) – center of the septum /


Congenital Heart Disease. Aetiology and incidence The incidence 0.8% of live births. Maternal infection or exposure to drugs or toxins may cause congenital.

defect Sinus venosus Least common Positioned high in the atrial septum ASD (atrial septal defect) Clinical Features Most children are asymptomatic for many years and the condition is often detected at routine clinical examination Qi/Qs > 1.5: symptoms (+) Effort dyspnea (exercise intolerance) Palpitation (Af/AF) Paradoxical embolism Pulmonary hypertension Eisenmenger syndrome Atrial Septal Defect. signs : Right ventricular heave S 2 widely split/


Acyanotic Heart Disease PRECIOUS PEDERSEN 1442. INTRODUCTION Left to right shunting lesions, increased pulmonary blood flow The blood is shunted through.

can cause extra flow and this is a condition called Eisenmenger syndrome  Examples: Patent Ductus Arteriosus (PDA) Ventricular Septal Defect (VSD) Atrial Septal Defect (ASD) Coarctation of the Aorta Atrial Septal Defect (ASD) ▪ Defect in the septum that divides right and /▪ The classic sign of a persistent PDA is a continuous “machine-like ” murmur. ▪ May lead to Eisenmenger syndrome, resulting in lower extremity cyanosis ▪ In the normal neonate, spontaneous closure of the ductus arteriosus in response to/


Sequelae of Congenital Heart Disease in the Adult Paul Reynolds, MD Uma and Sujit Pandit Professor and Chief of Pediatric Anesthesiology The University.

ASD) Patent Ductus Arteriosus (PDA) AV Canal (AVSD) Total Anomalous Pulmonary Venous Return (TAPVR) Left to Right Shunts volume overloaded ventricles decreased cardiac reserve pulmonary venous congestion reduced lung compliance and increased airway resistance pulmonary vascular obstructive disease Eisenmenger’s Syndrome/ is 28% Maternal mortality for pregnancy termination is 7% Kansaria JJ. Salvi VS. Eisenmenger syndrome in pregnancy. Journal of Postgraduate Medicine. 46(2):101-3, 2000 Apr-Jun Indications/


APPROACH TO CYANOSIS.

with Incrs PBF (largeVSD+ NO PS) Persistent Truncus SV without PS TAPVC Cyanosis with PAH and Diminished PBF (eisenmenger- defnd as nonreactive PAH resulting in a R to L shunt at atrial,ventricular or great artery level) /accentuated Systolic murmur in pulmonary area is insignificant or absent Pulmonary and/or TR murmurs may be present EISENMENGER SYNDROME-DIFFERENTIATION ASD VSD PDA CYANOSIS UNIFORM DIFFERENTIAL CARDIOMEGALY PRESENT ABSENT PARASTERNAL IMPULSE HEAVING MILD 2nd SOUND WIDE FIXED SPLIT SINGLE/


Kendra Marsh, MD Division of Cardiology, UIC Fellow

Atrium, allowing complete mixing of oxygenated and unoxygenated blood. Truncus arteriosus, complete mixing at aortic level. Pregnancy and ASD Well tolerated after closure Increased risk of paradoxical emboli peri and post partum Contraindicated in Eisenmenger Syndrome Maternal mortality 50% Fetal Mortality 60% TTE and ASD Transthoracic echocardiogram four chamber view to evaluate atrial septal defect. Note presence of inter-atrial communication between left and/


Adult with operated congenital heart disease: what should we check for? January 15 th, 2016 16h-17h30.

correct? A) Isolated complete AVSD in adults is an aetiology of Eisenmenger syndrome B) In case of pulmonary stenosis or banding, it may be still surgically correctable C) In case of Eisenmenger syndrome, specific medical therapy increases life expectancy D) Mitral clip is a /in adults is/are correct? A) It may be diagnosed during adulthood B) It is the association of ostium secundum ASD and mitral cleft C) Cyanosis is a symptom that may lead to diagnosis D) Percutaneous closure is the treatment of choice/


JAN BOGAERT Teaching Cases CLINICAL CARDIAC MRI SECOND EDITION Cases 61-80.

vein Abbreviations Ao, aorta / AR, aortic regurgitation / AS, aortic stenosis / ARVC-D, arrhythmogenic RV cardiomyopathy-dysplasia / ASD, atrial septal defect / AV, aortic valve / CAD, coronary artery disease / CMP, cardiomyopathy / CT, computed tomography //of Fallot + Waterston Anastomosis 41-year-old woman known with Waterston anastomosis for tetralogy of Fallot, presenting with Eisenmenger syndrome, right heart failure, cardiac cirrhosis and chronic renal insufficiency. Cardiac MRI: LV EDV 128 ml – EF /


Premchand Anne, MD, MPH PGY IV 9/1/2005

a large PDA=> Eisenmenger’s => differential cyanosis (lower body cyanosis): WHY? PDA ECD Endocardial cushion is responsible for upper part of ventricular septum and lower part of atrial septum Absence leads to VSD, primum ASD, clefts in / risk for cardiac transplantation immediate treatment for double aortic arch; risk for tracheomalacia immediate treatment for hypoplastic left heart syndrome; risk for right ventricular dysfunction Question-7 You are evaluating a 3-day-old infant brought to the emergency/


PHYSIOLOGICAL CHANGES IN PREGNANCY AND CONGENITAL HEART DISEASE COMPLICATING PREGNANCY.

LV wall thickness ↑ LVOT & RVOT velocities CONGENITAL HEART DISEASES COMPLICATING PREGNANCY L to R Shunts R to L Shunts Eisenmenger Syndrome Obstructive Lesions Risk Assessment Timing of Intervension Mode of delivery Contraception Left-to-Right Shunts L → R shunting ↑ chances /of PH, RV failure, arrhythmias Degree of shunting not affected : SVR & PVR ↓ to similar degree. ASD Common L to R shunt complicating pregnancy Even large shunts are well tolerated if Pul. resistance < 3.0 WU Prior /


Atrioventricular Septal Defect

vascular resistance may be increased above systemic arterial resistance later infancy Clinical manifestations Partial AVSD Patients with 10 ASD are usually asymptomatic during childhood.    Dyspnea, easy fatigability, recurrent RTI and growth retardation may be present/& PAH Those who survive without surgery into childhood usually develop pulmonary vascular obstruction and eventually die with Eisenmenger’s syndrome Berger and his colleagues found that only 54% of patients born with a complete form of AVSD /


MR-Imaging in diagnosis and follow-up post corrective surgery of congenital heart disease A.G. Opitz¹, P. Fries¹, A. Lindinger², H.-J. Schaefers³, A. Buecker¹,

- Pulmonary regurgitant fraction - Assessment of LPA and RPA Atrial Septal Defect (ASD) Most common CHD in adults All connections between right and left atrium 1//traversing the ventricular septum (arrow) from right to left indicating “Eisenmenger- reaction“). Patent Ductus arteriosus Physiologic shunt between MPA and descending/ APVR (0.3 - 0.5% of patients with CHD) Pulmonary Sequestration Scimitar Syndrome Pulmonary Atresia (with and without VSD) Pulmonary veins / arteries: PAPVR Pulmonary veins /


CARDIOVASCULAR SYSTEM Presented by Prof.Ahmed Mohy.

No shunt ) I-CHD with LT-RT SHUNT -PATENT DUCTUS ARTERIOSUS (PDA) -VENTRICULAR SEPTAL DEFECT (VSD) -ATRIAL SEPTAL DEFECT (ASD) 1-The blood is shunted from Lt-Rt because pressure in Lt. Side is higher than that in Rt. Side 2-The pulmonary/&failure 4-So,pressure in Rt.side exceeds that of Lt.side& reversal of shunt occurs ie. Rt.-Lt.shunt (EISENMENGER’S SYNDROME) CYANOSIS Patent Ductus Arteriosus (PDA) The ductus arteriosus, serves to shunt blood from pulmonary artery to aorta during intrauterine life/


Medical-Surgical Problems in Pregnancy Lectures 7, 8 Petrenko N.V., MD, PhD.

7 or 8 month Contraindications to pregnancy  Pulmonary hypertension  Shunt lesions associated with Eisenmenger syndrome  Complex cyanotic congenital heart disease  Aortic coarctation complicated by artic dissection  Poor ventricular function  Marfan syndrome with marked aortic dilatation Associated Cardiovascular Disorders  I Congenital cardiac disease ■ Septal defects  Atrial septal defect (ASD)  Ventricular septal defect (VSD)  Patent ductus arteriosus (PDA) ■ Acyanotic lesions  Coarctation of/


Pediatric Board Review 2014 Pediatric Cardiology

chest radiography request echocardiography request electrocardiography 6 Congenital Heart Disease- Structural PINK Shunts ( L to R) : ASD VSD PDA Stenosis: AS PS Coarctation HLHS BLUE TOF TGA Tricuspid atresia Truncus TAPVR Ebstein’s Single ventricle/ -cont... Natural history : Small VSDs close spontaneously depending on the site. Unrepaired the large defects may lead to Eisenmenger’s syndrome. VSD - cont….. Large VSDs are closed surgically by 6 months of age. Diuretics,digoxin and afterload reducing agents /


Assessment of Operability in CHD with PAH

Center Cochin Kerala, India Congenital Heart Disease 1940 1950 1960 1970 1980 1990 2000 Surgery for PDA Paul Wood: Eisenmenger syndrome, Open heart surgery for common shunts Early Open Heart surgery in Infants Infant open heart surgery widely established in developed/ Interv. 2008; 71:665-70 What else can be done in the cath lab? Test occlusion of the defects: ASD PDA Little validation with long term data Immediate reduction of PA pressure may not translate into long term benefits Illustrative Example/


Pediatric Board Review 2015 Pediatric Cardiology Prema Ramaswamy, M.D. Director, Pediatric Cardiology, Maimonides Infants and Childrens Hospital of Brooklyn.

4. request echocardiography 5. request electrocardiography Congenital Heart Disease- Structural PINK Shunts ( L to R) : ASD VSD PDA Stenosis: AS PS Coarctation HLHS BLUE TOF TGA Tricuspid atresia Truncus TAPVR Ebstein’s Single ventricle Normal/ -cont... Natural history : Small VSDs close spontaneously depending on the site. Unrepaired the large defects may lead to Eisenmenger’s syndrome. VSD - cont….. Large VSDs are closed surgically by 6 months of age. Diuretics,digoxin and afterload reducing agents /


Pediatric Board Review 2014 Pediatric Cardiology Prema Ramaswamy, M.D. Co-Director, Pediatric Cardiology, Maimonides Infants and Childrens Hospital of.

4. request echocardiography 5. request electrocardiography 6 Congenital Heart Disease- Structural PINK Shunts ( L to R) : ASD VSD PDA Stenosis: AS PS Coarctation HLHS BLUE TOF TGA Tricuspid atresia Truncus TAPVR Ebstein’s Single ventricle Normal /VSD -cont... Natural history : Small VSDs close spontaneously depending on the site. Unrepaired the large defects may lead to Eisenmenger’s syndrome. VSD - cont….. Large VSDs are closed surgically by 6 months of age. Diuretics,digoxin and afterload reducing agents /


Cardiovascular System

the mean pulmonary artery + the hilar pulmonary artery, vessels within the lung tissue are normal or small. * Eisenmengers syndrome : Greatly raised pulmonary artery resistance in association with ASD, VSD, & PDA leading to reverse shunt (i.e. : Rt. to Lt. shunt). Pulmonary Arterial Hypertension due to ASD & Eisenmengers syndrome * The cause of pulmonary arterial hypertension may be visible on the CXR as cor pulmonale & mitral valve diseases/


1 R. TANDON. 2 ECG, accurate physical examination and radiology form the tripod on which rests the clinical diagnosis in Ped. Card. Omission of, unfamiliarity.

Congestive cardiac failure + Age - NB 32 33 34 CONGENITAL HEART DISEASE Cyanotic Patients : Eisenmenger Phys. RAD RVHRAD LVHLAD LVHLAD RVH VSD, PDA, APW  RV TAAVC TGA Physiol. SV ASD 2°--- 35 36 37 CONGENITAL HEART DISEASE Cyanotic Patients : Pulm. Ven. Obstru. ‘P/ shunt AV canal defects Older pts of TA and ASD 2°. 50 Wide QRS tachycardia ALCAPA Coron. arterio-ven. fistula Arrhythmogenic RV dysplasia. 51 Atrioventricular conduction defects and pre-excitation syndrome Ebstein’s disease. Cong. CTGA 52 Age:3 /


Pediatric Cardiology.

pain is the most common cause 1-Costochondritis 2-Tietze syndrome 3-Precordial catch syndrome 4-slipping rib syndrome 5-Hyper sensetive xyphoid 6-Trauma & muscle strain 7/complain of some fatigue and dyspnea. Growth failure is very uncommon. Rarely, ASDs in infants are associated with poor growth, recurrent lower respiratory tract infection, and/, and is frequently seen in the adolescent and young adult. The eponym Eisenmengers complex is now applied to the condition characterized by a VSD with marked /


Congenital heart diseases CHD are the abnormalities of the heart or blood vessels that are present from birth. Disorders arise during the 3 rd to 8 th.

affected patients are increased risk of developing CHD. The three main classification are Malformations causing Left to right shunt 1.ASD 2.Patent foramen ovale 3.VSD 4.PDA 5.Atrio ventricular septal defect Consequences of Left right shunt  Volume /increase in the pressure more on the right side than the left side, leads to cyanosis  late onset  (EISENMENGER SYNDROME) Also called as TARDIVE CYANSOS Malformation causing right to left shunt 1.TOF 2.Transpositions of great arteries 3.Perstitent Trancus/


Congenital Heart Diseases -Congenital heart disease is a general term used to describe abnormalities of the heart or great vessels that are present from.

with hypertrophy. Late cyanosis. Congenital Heart Diseases Left-to-Right shunts.Left-to-Right shunts. Atrial Septal Defect (ASD) Ventricular Septal Defect (VSD) Patent Ductus Arteriosus (PDA) Atrioventricular Septal Defect (AVSD) Right-to-Left shuntsRight/to increase in right ventricular pressure, reduction in shunt volume and, finally, shunt reversal. This produces cyanosis (Eisenmengers syndrome). Shunt reversal in VSD occurs some time after birth (tardive cyanosis) and is associated with decrease or /


Congenital Heart Disease

by the increased flow across the right ventricular outflow tract into the pulmonary artery, not by low-pressure flow across the ASD. ASD VSD Incidence Most common CHD (20%) Coexists with other lesions in 5% Types Age presentation Most common CHD (20/-BVH if large 4. RVH-PVOD Increased vascularity with larger shunts and enlargement cardiac size Holt-Oram syndrome, Down’s, Trisomy 13, Trisomy 18 Eisenmenger’s Syndrome (shunt reverses to rightleft) Treatment VSD 1. Spontaneous closure of small VSD’s 2. Medical/


PRESENTED BY DR SANDEEP.R

(20%) ‘waterfall sign’ ‘Hilar comma sign’ Associated right aortic arch (33%) Concave PA segment ELEVATED RIGHT HILUM Eisenmenger’s syndrome PACEMAKER BIVENTRICULAR PACING RA LEAD RV LEAD PACEMAKER PROBLEMS LEAD FRACTURE DISPLACED RV LEAD DISPLACED RA LEAD ICD CARDIAC CALCIFICATIONS A)/ WITH DYSPNOEA MITRAL STENOSIS 65 YR OLD MAN WITH DYSPNOEA PERICARDIAL EFFUSION 35 YR OLD ACYANOTIC FEMALE ASD WITH PAH IDENTIFY THE ABNORMALITY SITUS INVERSUS WITH DEXTROCARDIA IDENTIFY THE ABNORMALITY RT AORTIC ARCH WITH RT /


A Review of Congenital Heart Disease

ASD or PFO into the LA Total Anomalous Pulmonary Venous Return When the anomalous pulmonary veins enter the brachiocephalic vein and the persistent left superior vena cava, there is a “snowman” or “figure 8” appearance created by a large supracardiac shadow along with the normal cardiac shadow Total Anomalous Pulmonary Venous Return “Snowman” or “Figure 8” Eisenmenger Syndrome/young adult Eisenmenger Syndrome Symptoms: Cyanosis Exertional dyspnea Fatigue Hemoptysis palpitations Eisenmenger Syndrome Physical /


Assessment for operability of

ppm 3/15 (20 %) pt with PVR > 8 u fall in PVR < 6 after NO Response same in those with Down Syndrome Yasuda T et al,Paediatric Cardiol,2000 NO vs NO + Oxygen combination Number of responders with combination significantly > than when NO/Oxygen/ PAH : Sildenafil PAp (m) ↓ 3-5 mms Ex. capacity ↑ Side effects – minor Functional class ↑ CONGENITAL HEART DISEASE PAH : Eisenmenger ASD 40 pts., FU – 4 years, PVR ↑ 7u ASD closed 26, Med. Rx -14 PVR 9-14 - No ↑ in PVR 7-9 - PVR ↓ No vasoreactivity check pre op PVR /


Embryology Review.

ASD, VSD, AV Canal and persistent truncus arteriosus are holes in the septa They cause LR shunts after birth, which result in right ventricular hypertrophy, pulmonary hypertension, and if severe, congestive heart failure/death Why are we looking? Sx: fatigue, failure to thrive Eisenmenger’s syndrome/) Tx: surgery Cardiac Defects III Persistent AV Canal Often seen in Down’s syndrome Failure of endocardial cushion fusion, leads to ASD and VSD Results in LR shunt Dx: echocardiography Sx: CHF (more severe/


Patent Ductus Arteriosus

Cardiac Lesions Anomalies Charateristics Acyanotic LR Shunt = ↑ PBF Triad: FFT Chest infections CCF PDA ASD VSD A-V Canal 2. Obstructive Often asymptomatic Coarctation Aortic stenosis Pulmonary stenosis Cyanotic 3. Decreased PBF/ / transcatheter closure Patent Ductus Arteriosus Physiological Classification Moderate size PDA: Moderate pulmonary hypertension Do not develop Eisenmenger syndrome Mild symptoms: some growth retardation, fatigue on effort May be asymtomatic Presence of loud murmur with diastolic/


Echocardiographic assessment of Patent Ductus Arteriosus

TEE for PDA TEE is not that popular among the PDA cohort in its incremental benefit in echo diangnosis, compared to ASD, VSD and complex congenital heart disease Inherent difficulties in imaging TEE imaging -In high esophageal position (~20-35cm), probe rotated /–97% vs 42% and TEE NPV 98% vs 68%, ; p<0.001) for confirming the presence of PDA For PDA Eisenmengers syndrome, the sensitivity of TEE in confirming diagnosis of PDA was 100% vs 12% (p<0.01), Diagnostic Accuracy of Transesophageal Echocardiography /


七院聯合病例討論會 三軍總醫院 R2 李宗翰 / Vs. 喩永生主任.

Conditions directly affecting pulmonary arteries Primary pulmonary hypertension Toxin-induced (ie, anorexic agents) Vasculitis Granulomatoses, collagen-vascular disorders, arteritis Hepatic cirrhosis/portal disease Congenital heart disease (Eisenmenger syndrome [ASD, VSD, PDA]) Infection Human immunodeficiency virus Causes of pulmonary hypertension Conditions affecting pulmonary parenchyma Chronic obstructive lung disease Infiltrative/granulomatous diseases Sarcoidosis, pneumoconiosis, radiation, fibrosis/


CARDIAC DISEASES IN PREGNANCY DR. RAZAQ MASHA,FRCOG Assistant Professor & Consultant Department of Obstetrics & Gynaecology.

well. Women with uncorrected lesions require special management. The most uncontrolled lesions are: Atrial Septal Defects (ASD) Atrial Septal Defects (ASD) Patent Ductus Arteriosus (PDA) Patent Ductus Arteriosus (PDA) Ventricular Septal defect (VSD) Ventricular Septal defect/ and right-to-left shunt through any communication between the systemic and pulmonary circulation is know as Eisenmenger syndrome. If however, the shunt is substantial resulting in many years of increased pulmonary blood flow, pulmonary/


Development of the circulation system 陳建榮

right atrium; LA - left atrium. 原隔 原孔 次孔 次隔 Fossa ovalis 卵圓窩 Atrial septal defects 心房間隔缺損 (ASD) Atrial septal defects (ASD) are fairly common, present in 10-15% of patients with congenital cardiac anomalies. It is more commonly /: -Pulmonary valve stenosis -Ventricular septal defect -Overriding aorta -Hypertrophy of right ventricle Eisenmengers syndrome( 森曼格綜合症 ) Characteristics of Eisenmengers syndrome: -persistent truncus arteriosus -ventricular septal defect -left-right ventricular shunt -right ventricle/


MITRAL REGURGITATION Rami Khouzam, MD

Rheumatic fever Mitral annulus calcification: age-related Infective endocarditis Congenital: cleft of anterior MV associated with primum ASD 2- Defective tensor apparatus: Abnormal chordae tendineae: Idiopathic/ endocarditis/ MVP/ Trauma Papillary muscle dysfunction: /following conditions is not considered a contraindication to pregnancy? A. Eisenmengers syndrome. B. Moderate primary pulmonary hypertension. C. The Marfan syndrome with aortic root dilatation. D. Moderately severe mitral regurgitation. /


Internal Medicine Board Review- Cardiology

to result in Eisenmenger’s syndrome and severe pulmonary hypertension Eisenmenger’s syndrome End-stage of/ congenital heart disease with initial L>R shunt Persistent increase in pulmomary blood flow results in vasculopathy, increased PVR and eventually R to L shunt with hypoxia Treatment is heart-lung transplant, and palliative therapies (O2, vasodilators,etc.) Suspect this in 2nd-3rd decade of life for VSD, 5th-6th decade for ASD/


Congenital Heart Diseases: Atrial Septal Defect. Patient History This is a case of G.L., a 21 year old female, complaining of easy fatigability and occasional.

block Diffuse ST-T changes Chest Radiograph Cardiomegaly with multi-chamber enlargement Pulmonary congestion 2D- Echocardiography ASD, ostium secundum type Markedly dilated right bentricle with adequate wall motion and contractility with evidence of RV/perinatal distress, or perinatal hypoxia may be present most children with small defects remain asymptoma-tic In patients with Eisenmenger syndrome, symptoms in adult life consist of exertional dyspnea, syncope and hemoptysis R-L shunt leads to cyanosis, /


YOUR LOGO Case Presentation Thoracic and Cardiovascular surgery department, SMC 2007313075 Son Eui Young.

baby, C/sec d/t PPROM and breech presentation, Apgar score 2/2 으로 출생  출산 후 시행한 TTE 상 VSD 및 ASD 소견 관찰  이에 대해 further evaluation 및 management 위하여 본원 NICU 전원 Page  3 YOUR LOGO Other Histories  Development: normal/사망할 수 있음 YOUR LOGO Complication  Growth failure  Congestive heart failure (left heart failure)  Pulmonary vascular disease :as Eisenmenger syndrome or complex  Severe illness with viral or bacterial pneumonia  Infective endocarditis  Aortic regurgitation  Stenosis in the right ventricular /


Dr. Talaat Ali Sabeeh Al-Jarrah Pediatric Cardiologis t.

same ASD. Treatment Surgery is always required. Treat congestive symptoms. Pulmonary banding may be required in premature infants or infants < 5 kg. Correction is done during infancy to avoid irreversible pulmonary vascular disease (Eisenmenger `s syndrome). /left outflow tract. 3-Supravalvular – involves the ascending aorta is the least common. Question. Which syndrome with Supravalvular AS? Answer: Williams Syndrome Hemodynamic: Pressure hypertrophy of the LV and LA. Mild AS 20-40mmHG Moderate AS 40-60mmHg/


Acyanotic CHD Dr.Emamzadegan Pediatric & Congenital Cardiologist.

Aneurysms of the descending aorta or the enlarged collateral vessels may develop. Infective endocarditis or endarteritis CoA PHACE syndrome : posterior brain fossa anomalies, facial hemangiomas, arterial anomalies, cardiac anomalies and CoA, eye anomalies; may/septal leaflet of TV Partial defect: ASD primum +MR (cleft) Endocardial Cushion Defect Pathophysiology :ASD+VSD+ AV valve insufficiency Clinical manifestation: CHF over the 6-8 w of life, PH (eisenmenger,PVOD) Down syndrome: near 50% with CAVSD Murmur /


Thomas Hoy Department of Biomedical Engineering BME 273 Senior Design January 30, 2004.

.Isolated secundum atrial septal defects of significance occur in approximately 70,000- 100,000 individuals today. Isolated ASDs can cause congestive heart failure or Eisenmengers syndromeIsolated ASDs can cause congestive heart failure or Eisenmengers syndrome Goals To develop a less costly occlusion device for an ASD. To develop a less costly occlusion device for an ASD. To develop an occlusion device that is easily sized to the/


Imaging Conference 12/15/09 A. Zucker

peripheral emboli: Transient flow reversal secondary to increased R side pressures (valsalva) PFO Pulmonary hypertension Migraine headaches: PFO > ASD Pulmonary hypertension: Seen in less than 10% of pts w/ ASD at presentation Seen in 50% of individuals above the age of 40. Progression to Eisenmengers syndrome occurs in 5 to 10% of individuals late in the disease process Altitude intolerance Increased decompression sickness and/


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