Ppt on eisenmenger syndrome definition

>>0 >>1 >> 2 >> 3 >> 4 >> Diagnostic Ultrasound 10/5/2015 1 Dr.sai krishna.

characterized by ulceration, oedema, mineralization, submucosal arteriopathy, gastric gland atrophy and necrosis.Ultrasonographic changes include: Poor definition of gastric wall layers Mineralization of the gastric mucosa, seen as a hyperechoic line adjacent to the / Dr.sai krishna >>0 >>1 >> 2 >> 3 >> 4 >> Tricuspid dysplasia: Similar to MVD Eisenmenger’s syndrome and other malformations: Eisenmenger’s syndrome, a communication between the right and the left side of the heart (at the level of the atria/


has virtually disappeared in the study of congenital heart disease because in general the patients require more definitive studies such as cardiac catheterization, angiocardiography, ultrasonography, and MRI. Cardiovascular fluoroscopy no longer has widespread use/, the vessels within the lung being normal or small. When the pulmonary hypertension is part of Eisenmengers syndrome (greatly raised pulmonary arterial resistance in association with atrial septal defect, ventricular septal defect or patent /

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

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 regurgitation/ radiological picture of TOF is called (boot shape). Echo: It is essential for Dx. Catheterization: Gives the definitive Dx and as a preoperative step. COMPLICATIONS: 1-Hypercyanotic spells. 2-Cerebrovascular accidents (CVA). 3-Cerebral abscess./

Circulation system 陳建榮 http://web.nchu.edu.tw/pweb/users/chenjr/

This is the compartment destined for further partition to the definitive atria.  Primitive ventricle (PV) 心室原基 This is the compartment destined for further partition to the definitive ventricles.  Bulbus cordis (BC) 心球 This will contribute to/: Pulmonary valve stenosis Ventricular septal defect Overriding aorta Hypertrophy of right ventricle Eisenmengers syndrome Characteristics of Eisenmengers syndrome: persistent truncus arteriosus ventricular septal defect left-right ventricular shunt right ventricle /

PAH and Lung Transplant FRACP Teaching 2007 TJ McWilliams Respiratory Physician.

Definite: Gender Possible: Pregnancy, Systemic ↑ BP  Diseases Definite: HIV Very Likely: Portal ↑ BP/Liver Disease, CTD, CHD Causes of Secondary Pulmonary Hypertension Obesity, Kyphoscoliosis, Neuromuscular Disease COPD, Pulmonary Fibrosis Collagen Vascular Disease Scleroderma (CREST), SLE HIV, Drugs Eisenmengers/Mortality  BOS  Infection  Renal Impairment  Malignancy  Osteoporosis Bronchiolitis Obliterans Syndrome (BOS)  Manifestation of chronic rejection Still the most significant limitation to long/

Development of the circulation system 陳建榮

is the compartment destined for further partition to the definitive atria. Primitive ventricle (PV) 心室原基 This is the compartment destined for further partition to the definitive ventricles. Bulbus cordis (BC) 心球 This will /: -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/


— 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. / vena cava can be seen in sinus venosus defect. Transthoracic and Trans esophageal echocardiography can provide excellent definition of the atrial septum. TEE is also useful in guiding device placement during catheter ASD occlusion procedures /

Paediatrics 2 Cardiothoracic & renal. What we will cover: Cardiac problems; Congenital heart disease Rheumatic fever Infective endocarditis Respiratory.

-6m if significant Risks: arrhythmia, sudden death, IE, AV prolapse/AR, Eisenmenger’s Patent Ductus Arteriosus Causes: rubella, prematurity, prenatal hypoxia, malformations 1-2/ Management R to L shunts (ToF)  ABC  PG infusion (duct-dependent)  Definitive surgery (close VSD 6m, relieve PS)  Tet spells: sedation, morphine, chest-knee /Truncus arteriosus AVSD (Down’s syndrome) Complex e.g. tricuspid atresia Aortic stenosis Pulmonary stenosis Hypoplastic left heart syndrome Rheumatic fever Now rare in /

Medical Disease in Pregnancy Cardiovascular Disease Cullen Archer, MD Department of Obstetrics and Gynecology.

associated with pulmonary HTN and L to R shunting Ventricular Septal Defects Large unrestrictive VSDs permit equalization of right and left pressures Eisenmenger’s syndrome Congenital Aortic Stenosis Outflow obstruction Antepartum Peripartum Pulmonic valve stenosis Usually tolerated well Severely stenotic valves Cautious use of IVF Shorten second/ Preeclampsia Hypertensive disorder of pregnancy Newly onset after 20 weeks gestation Proteinuria Risk factors HELLP Syndrome Definition Complications


— 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. / vena cava can be seen in sinus venosus defect. Transthoracic and Trans esophageal echocardiography can provide excellent definition of the atrial septum. TEE is also useful in guiding device placement during catheter ASD occlusion procedures /

Path Final Exam Practice. A Couple Notes Thanks to the rockstars who helped put this together! For most of the questions, answer choice F is meant as.

choices A and B present at birth with a L  R shunting of blood that may potentially develop shunt reversal (Eisenmenger syndrome) but would affect all extremities equally. TOF presents with VSD, overriding aorta, obstruction of the right ventricular outflow, and/. Question 143 The tissue pictured here was taken from a new- born with Hyaline Membrane Disease. What other condition is definitely present? A. Jaundice B. Neural tube defect C. Hydrocephalus D. Athymia E. Cherry red spot on macula Question 143/


beenshown that 3% of the patients with a defect of 1.5 cm or smaller will develop Eisenmenger’s syndrome whereas half of patients with larger defect will develop pulmonary hypertension , which will also appear earlier/various parameters are: Clinical , haemodynamic and echocardiographic parameters. Exercise evaluation. Biochemical markers . Comprehensive prognostic evaluation. Definition of patient status. BIOCHEMICAL MARKERS : biochemical markers emerged within the last decade as an attractive non-invasive /

Atrioventricular Septal Defect

CHF & 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 were/mitral valve function Special Problems in Complete AVSD Surgery Right or Left Ventricular Hypoplasia The only option for definitive surgical treatment is the modified Fontans procedure preceded by adequate pulmonary artery banding in infancy Subaortic Stenosis If/

Fetal Circulation. Normal Heart Cardiovascular Exam in the Child with Heart Murmur Epidemiology Innocent murmur - 12,050 schoolage children from.

Recurrent Pneumonia Chronic Respiratory Sx, Exercise Intolerance Failure to Thrive Pulmonary Vascular Obstructive Disease (Eisenmenger’s) Endocarditis Risk Premature Death Large VSD – Subsequent Course/Complications Diuretics Afterload Reduction Inotropes/ lupus, phenylketonuria) Definition: Oxygenated and deoxygenated blood mix completely before delivery to the aorta and pulmonary arteries Examples: total anomalous pulmonary venous connection; hypoplastic left heart syndrome Classification of Congenital /

先天性心脏病 Congenital Heart Disease (CHD)

to detect and estimate the PH in PDA patient in clinical experience? Why? Important Concept: Pulmonary hypertension differential cyanosis (Eisenmenger syndrome) A widened Pulse Pressure Tetralogy of Fallot (TOF) 法洛四联症 Learning objectives You should; Know the signs , symptoms, /than 6 months ,those who are medically unfit for a major procedure, and those with hypercyanotic spells The definitive repair involves total reconstruction of the RV outflow tract and closure of VSD, The operative mortality is less /

Assessment of Operability in CHD with PAH

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/ developing world 100% Developed world Percentage of infants with large VSD receiving timely surgery Developing world Pulmonary Vascular Obstructive Disease Definition:  PVR in CHD (Qp) Precludes safe closure PAp high after closure; may further  Timely CHD correction:/

Review Physiological Integrity of Children Question and Answer.

to hold, touch, talk to and look at the infant to promote bonding. The prognosis is very good unless Eisenmenger’s syndrome develops. Physiological Integrity of Children Oxygenation (Cardiovascular) Health 66. What nursing information most accurately describes the cardiac defect/ of one leg C.Audible click on hip manipulation D.Unilateral droop of the hip C. This is the definition of Ortolani’s sign where there is an audible click and indicates hip dysplasia. Physiological Integrity of Children Mobility /

Lung Transplant Dave Sweet. CASE You are currently the fellow working at VGH and as you come in Monday morning the charge nurse tells you that there are.

1) Alpha1-antitrypsin 2) CF 3) COPD 4) IPF (UIP and occ NSIP) 5) IPAH (including Eisenmengers) 6) Sarcoidosis CASE What are the general goals for determining the appropriateness of a lung transplant in a individual/definitive tests to prove this is not rejection? Biopsy!! Patients with acute rejection can also have alveolar infiltrates, hypoxemia and systemic inflammatory response syndrome. Patients with acute rejection can also have alveolar infiltrates, hypoxemia and systemic inflammatory response syndrome/

Cardiac Physical Diagnosis: A Proctor Harvey Approach

extractions of teeth but also for the simple procedures of cleaning and/or filling. Infective endocarditis has been definitely documented to occur with these simpler procedures. Antibiotic prophylaxis should also be given to patients with valvular /are only a few conditions that cause a “giant” A-wave in the jugular venous pulse: Pulmonary hypertension (“Eisenmenger syndrome”)- pulmonary hypertension, with atrial defect, ventricular defect, and patent ductus arteriosus) can cause pressure to be reflected /

Pediatric Congenital Heart Disease. CHD Incidence: 5-8 per 1000 live births –Major cause of death in first year of life (after prematurity) –Most common.


Dr. A.R.Pintilie. 1.Cardiovascular Diseases 2.Urinary Tract Infections 3.Gastrointestinal Disorders 4.Diabetes 5.Infections 6.Neoplastic Diseases 7.Uterine.

artificial valve Group 3 (mortality 25-50%): - pulmonary hypertension - aortic coarctation with valvular involvement - Marfans syndrome - Eisenmengers syndrome The lesions are classified according to the functional grading of the New York Heart Association as follows: => class/and oxygenation are often critical matters; => treatment of hypocalcemia and hyperbilirubinemia. Gestational diabetes Definition Gestational diabetes implies that this disorder is induced by pregnancy, perhaps due to exaggerated /

Cardiology Board Review

pathologic Cardiac Exam Observation Palpation Ausculatation Respiratory distress? Central cyanosis? Clubbing? Syndromic appearance? Palpation Hyperdynamic precordium? Displaced PMI? HSM? Distal pulses equal/ not occur→ no left-to-right shunt→ could develop Eisenmenger’s and irreversible pulmonary vascular changes→ now right-to-left/particularly malignant form of LQTS Torsades de Pointes Infective endocarditis Definition and Epidemiology Definition: Inflammation of the valvular or mural endocardium, caused by/

Anesthesia for Congenital Heart Disease Glynne D. Stanley MB.ChB. FRCA.

or ASD –If these are restricted then there is systemic venous congestion Congenital Cardiac Surgery Tricuspid atresia –Palliative and definitive procedures are applicable to any patient with univentricular physiology –The single ventricle always becomes the systemic ventricle –Initial palliative/RLN damage Rising PVR can eventual lead to a Rt to Lt shunt through an ASD or VSD, Eisenmenger’s syndrome End-tidal CO 2 will frequently underestimate PaCO 2 due to reduced pulmonary flow and increased dead space /

Cardiomyopathy, End-stage Heart Disease & Transplantation Seoul National University Hospital Department of Thoracic & Cardiovascular Surgery.

hypertension Elevated right atrial pressure Thromboembolism in great LV with atrial fibrillation Restrictive Cardiomyopathy  Definition A cardiac muscle disease that results in impaired diastolic function with loss of compliance  /  Results Lung Transplantation Cystic fibrosis Primary pulmonary hypertension Interstitial lung disease Congenital heart disease with Eisenmenger syndrome Others such as obliterative bronchiolitis, bronchopulmonary dysplasia, bronchiectasis  End-stage respiratory failure as a /

1 May 2013 Dr Samantha Russell. 1. Autoimmune Disorders 2.Cardiovascular Disease 3. Endocrine Disorders 4. Hematologic and Coagulation Disorders 5. Human.

maternal morbidity and mortality in the United States Significant morbidity in pulmonary HTN, Eisenmenger’s syndrome, and severe cases of Marfan’s syndrome Maternal outcomes correlate with NYHA functional classification If complete repair and normal cardiovascular function/ hypertension and preterm birth in patients with epilepsy Management ?surgical repair HD stability NA techniques No definite advantage of certain delivery. If vaginal reduce 2 nd stage and attenuate blood pressure fluctuations Management /

In the Name of God Obstetrics Study Guide 4 Mitra Ahmad Soltani 2008.

bid po Not to exceed 1.2 mg/day Which is true about a 12 wk pregnant woman with Eisenmenger syndrome? A- therapeutic abortion is indicated B-heparin throughout pregnancy should be given C-pregnancy should be terminated when /The British Thoracic Society & Scottish Intercollegiate Guidelines Network Thorax 2008 May; 63 (Suppl 4) : 1-121 with permission Definition of asthma “A chronic inflammatory disorder of the airways … in susceptible individuals, inflammatory symptoms are usually associated with widespread/

Ostium Secundum Atrial Septal Defect Closure Thomas Hoy Department of Biomedical Engineering BME 272 Senior Design.

000- 100,000 individuals today. Isolated ASDs can cause congestive heart failure or Eisenmengers syndromeIsolated ASDs can cause congestive heart failure or Eisenmengers syndrome Techniques Used Today Surgical Suture & Surgical Patch Surgical Suture & Surgical Patch Both/1976Pioneer in 1976 Minimally invasive with excellent resultsMinimally invasive with excellent results Both Cost The Same Project Definition To design a device that should: To design a device that should: Provide more accurate /

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.

, 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/ Congestion and Edema Management Medical Watch out for dev’t of complications »Arrhythmias, CHF, endocarditis Operative repair: definitive –Patch of pericardium or of prosthetic material –Percutaneous transcatheter device closure –Indications: symptomatic significant L to R /

Ventricular Septal Defect Seoul National University Hospital Department of Thoracic & Cardiovascular Surgery.

Definition A hole or multiple holes in the interventricular septum. A VSD may be part of another major cardiovascular anomaly and may be acquired, and primary VSD may have minor coexisting morphologic abnormalities 2. History Roger: 1st description in 1879 Eisenmenger/ later in life Shunt reversal (right-to-left) due to elevated pulmonary vascular resistances leads to systemic hypoxemia (Eisenmenger syndrome) Morphology of VSD 1. Size 1) Large : approximately the size of aortic orifice 2) Moderate : still/

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

Thomas Hoy Department of Biomedical Engineering BME 273 Senior Design January 30, 2004 Project Definition What is a Ostium Secundum Atrial Septal Defect? What is a Ostium Secundum Atrial /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/

Pulmonary Hypertension Heart Disease (Braunward)

left heart Cardiac angiography Left-to-right shunt and location of shunt Right-to-left shunt and location of shunt Anatomical definition Peripheral pulmonary artery stenoses Intrapulmonary arterial pressure Pulmonary angiogram Intrapulmonary arterial pressure gradients Pulmonary arterial branch stenoses Proximal pulmonary arterial / Flow Through the Pulmonary Vascular Bed Pulmonary parenchymal disease COPD, interstitial lung disease Eisenmenger syndrome Pulmonary thromboembolism Thanks for Your Attention


CLASSIFICATION Presented by: Dr RAKESH JAIN Senior Resident, Dept of cardiology Medical College, CALICUT DEFINITION OF PAH Current hemodynamic definition is a mPAP >25 mm Hg PCWP, LA pressure, or LVEDP ≤15 mm Hg,/alveolar wall Grade VI: Acute necrotizing arteritis. A severe reactive inflammatory exudate is seen through all layers of the vessel EISENMENGER SYNDROME Defined as CHD with initial large systemic-to-pulmonary shunt that induces progressive pulmonary vascular disease and PAH, with resultant /


Treatment James L. Angtuaco, M.D., DPPS, DPSPC, FPCC Pediatric Cardiologist DISCLAIMER OBJECTIVES: To discuss the definition of Pulmonary arterial hypertension To discuss the different pathology / pathobiology of Pulmonary arterial hypertension To describe the classifications/ RECEPTOR ANTAGONIST BOSENTAN oral active dual (ETa and ETb) receptor antagonist for PAH (IPAH, CTD associated PAH, Eisenmenger’s syndrome) start at 62.5 mg. twice daily and uptitrated to 125 mg. bid after 4 weeks improvement in /


that ECG’s are the gold standard in defining dysrhythmia’s  Understand the basic mechanism of sinus rhythm, along with it’s definition ECG Part II – John N. Hamaty, D.O.  Become familiar with the most common dysrhythmia’s such as atrial / complete understanding of the pathophysiology of left to right (unidirectional shunts) as well as bidirectional shunt physiology, particularly Eisenmenger’s Syndrome A 33-year old mentally challenged male was brought to the office by his case worker; they state that /

Tricuspid Valve Disease & Endocarditis Department of Thoracic & Cardiovascular Surgery Seoul National University Hospital.

valve pathology Eisenmenger’s syndrome Primary pulmonary hypertension Marfan syndrome and other myxomatous disease Blunt or penetrating chest trauma Dilated cardiomyopathy in the late stages Infectious endocarditis Carcinoid syndrome Rheumatic disease of/ evdence of active infection with organism consistent with IE Infective Endocarditis Modified Duke Criteria (Diagnosis) Definite infective endocarditis Pathologic criteria (1) Microorganisms demonstrated by culture or histologic examination of a vegetation,/

Some Medical Conditions in Pregnancy Max Brinsmead PhD FRANZCOG August 2012.

countries  Risk of maternal and fetal mortality Also has substantial morbidity and economic sequelae Haematocrit and Perinatal Mortality A Definition of Anaemia: WHO definition is Hb <110 g/L but… Hb <100 g/L is more realistic Needs correction for altitude… Add/for the first time… F inger Clubbing here is most likely due to… Cyanotic congenital heart disease Tetralogy of Fallot Eisenmenger’s Syndrome And you should be worried because there is a very poor prognosis For the mother For the fetus Other High /

Cyanotic Heart Disease; Overview of Management

Shaker MD Cardiology Definition Cyanotic Heart Disease /D-TGA) –Single ventricle –Truncus arteriosus –Total anomalous pulmonary venous connections –Ebstein’s anomaly –Eisenmenger’s disease Ductal Independent Mixing Lesions: -Truncus Arteriosus . -d-Transposition of Great Arteries. -Total/ Decreased Pulmonary Blood Flow Lesions with Ductal Dependent Systemic Blood Flow: -Hypoplastic Left Heart Syndrome (HLHS). -Interrupted Aortic Arch. -Total Anomalous Pulmonary Venous Connection with Obstruction. Increased/

Congenital Heart Disease

medium used in that technique. Noninvasive Diagnostic Studies Cardiac catheterization and selective angiocardiography are the most definitive diagnostic techniques currently available for use in congenital heart disease. However, noninvasive studies often provide /of cases. In the most severe cases, an irreversible plexiform arteriopathy丛状的动脉病, similar to that seen in Eisenmenger syndrome or primary pulmonary hypertension, is present. Congenital Cardiac Anomalies in Children Atrial Septal Defect As a result/

Heart. Congestive heart failure or heart failure : condition : heart is unable to adequately pump blood throughout the body.

of an uncorrected secundum ASD pulmonary hypertension, right-sided heart failure, atrial fibrillation or flutter, stroke Eisenmengers syndrome. 2. Ostium primum atrial septal defect endocardial cushion defect defect in the atrial septum at the level/ if prolonged 5. Effective local anesthetic – maximum epinephrine 0.036 mg, aspirate, injection slowly Ischemic heart disease Definition weakened heart pumps (due to previous heart attacks or due to current blockages of the coronary arteries) Cardiomyopathy -/

Cor Pulmonale Faculty of Medicine Universitas Brawijaya Malang.

heart disease Can arise in patients with a variety of congenital shunts and can persist following corrective surgery. Eisenmengers syndrome most severe form 1,2 PAH associated with schistosomiasis PAH associated with sickle cell disease 1. Simonneau G et/ with congenital heart disease European and US guidelines recommend annual screening with Doppler echocardiography 1,2 Right heart catheterisation required for definitive diagnosis 1. Galiè N et al. Eur Heart J 2009; 2. McGoon M et al. Chest 2004 35 The/

Respiratory Failure: an introduction Ramadan M Bakr MBBch, MSc, DM, DC, DHA, DIS, MD MACCP, MERS, MESC. Professor of Chest Diseases, Menoufiya University.

ومنْ يُرد أنْ يُضِلَهُ يَجْعلْ صَدْرَهُ ضيقاً حَرِجَاً كَأنَما يَصَعد فى السماء“ (صدق الله العظيم ( الأنعام 125 Respiratory Failure Definition Respiratory failure is a syndrome in which the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide /ventilation (Shunting) Intra-cardiac –Any cause of right to left shunt eg Fallot’s, Eisenmenger Intra-pulmonary –Pneumonia –Pulmonary oedema –Atelectasis –Collapse –Pulmonary haemorrhage or contusion Perfusion without /

Truncus Arteriosus Seoul National University Hospital Department of Thoracic & Cardiovascular Surgery.

Truncus Arteriosus Seoul National University Hospital Department of Thoracic & Cardiovascular Surgery Truncus Arteriosus 1. Definition Congenital cardiac malformation in which one great artery, arising from the base of heart by /to 2.8% of CHD 2. Survival 50% survival in 1 month 18% survival in 6 months 12% survival in 1 year Others : Eisenmenger syndrome (death in 3rd decade) 3. Modes of death. Congestive heart failure in early life. SBE, cerebral abscess, pulmonary vascular disease. Survival is favorably/

Cardiovascular overview Cardiac function and heart failure Valvular disease and endocarditis Pericardial diseases Coronary artery disease Arrhythmias and.

Which letter corresponds to the first heart sound? 2. Which letter corresponds to the second heart sound? Heart Failure: Definition Problem with the heart which results in inability to eject an adequate amount of blood to meet the demands of the / of the great arteries: Aorta arises from RV and PA from LV.Need PDA or ASD/VSD to survive. Eisenmenger’s syndrome: Severe irreversible pulmonary hypertension secondary to chronic volume overload with reversal of left to right intracardiac shunt Coagulation: What’s/

NUR 409/Fall2014-2015. What is respiratory Failure???

, and an arterial pH less than 7.35. This definition is valid only in cases in which baseline ABG values are/ Hypoventilation Normal  Intra-cardiac ◦ Any cause of right to left shunt  eg Fallot’s, Eisenmenger  Intra-pulmonary ◦ Pneumonia ◦ Pulmonary oedema ◦ Atelectasis ◦ Collapse ◦ Pulmonary haemorrhage or contusion Intra/ reduction in alveolar surface area  Causes include: ◦ Acute Respiratory Distress Syndrome ◦ Fibrotic lung disease FIO2FIO2 Ventilation without perfusion (deadspace ventilation) /

Catheter Based Treatment of Adult Congenital Heart Disease Zoltan G. Turi, M.D. Robert Wood Johnson Medical School August 21, 2004

blood flow Resistance = Wood units. Multiply by 80 for dynes-sec-cm -5 Pulmonary Hypertension ● Variable definitions but typically: – mPA 30 = mod, > 45 = severe ● Nl PVR = 1- 3 /–Infundibular hypertrophy –Treat with beta blockade Surgery for dysplastic valves (Noonan’s syndrome) Resultant mild or moderate PI well tolerated –RV handles volume overload well /1, PA systolic pressure > 50 mm Hg, ↓’ ing LV function, non-Eisenmenger’s physiology Question 1 A 50 year old patient with dyspnea is referred to you/


IPAH) Familial (FPAH) Associated with (APAH): Connective tissue disease Congenital systemic-to-pulmonary shunts-Eisenmenger’s syndrome Portal hypertension HIV infection Drugs and toxins Other (thyroid disorders, glycogen storage disease, Gauchers /guidelines recommend annual screening with Doppler echocardiography.1-3 Right heart catheterisation still only method for definitive diagnosis TOOLS FOR SCREENING Clinical suspicion History and Physical Doppler echocardiography. SCREENING HIGH RISK POPULATION /

Ivan M. Robbins, M.D. Adult Pulmonary Hypertension Center

Systemic disorders: vasculitis 3.Metabolic disorders 4.Others: chronic renal failure on dialysis Definitions Definition of PH: Definition of PAH: mPAP > 25 mm Hg at rest Definition of PAH: PWP < 15 Normal LVEF No left-sided valvular disease PAH:/-pleural effusion is uncommon CT: -PA >aorta -cardiomegaly, enlarged RV -pericardial effusion CXR in PAH CXR in Eisenmenger Syndrome Mitral Stenosis Enlarged main PA on CT Standard view Coronal view Ventilation Perfusion Lung Scan CTEPH PAH Evaluation for Chronic /

Professor Emerita of Pediatrics Columbia University College of Physicians & Surgeons New York, New York ROBYN BARST, MD Consensus Updates in PAH Classification,

Due to Drugs and Toxins Simonneau G, et al. J Am Coll Cardiol. 2009;54(suppl 1):S43-S54. Definite Risk Aminorex Fenfluramine Dexfenfluramine Toxic rapeseed oil Possible Risk Cocaine Phenylpropanolamine St. John’s wort Chemotherapeutic agents SSRI Likely Risk Amphetamines/ at 1.6 to 12.5 cases per million adults — May result in PAH if not repaired early in life — Eisenmenger Syndrome – severe PAH with reversal of shunt direction Post switch repair transposition of the great vessels Simonneau G, et al. J /

Care of Child with Cardiovascular Disorders

decreases Pressure in left side of heart increases Pressure increases in aorta Congenital Heart Diseases ♥ Definition: It includes primarily anatomic abnormalities present at birth that results in abnormal cardiac functions The /hypertrophy Deficient systemic blood flow High risk of bacterial endocarditis and pulmonary vascular obstruction disease May develop Eisenmenger syndrome refers to the combination of systemic-to-pulmonary communication, pulmonary vascular disease and cyanosis Diagnostic tests: /

Hessami.MD1394. Approximately 2% of pregnancies involve maternal cardiovascular disease Cardiac disease may sometimes be manifested for the first.

, pregnancy is more likely to be associated with complications. In the setting of severe pulmonary vascular disease (Eisenmenger syndrome) maternal mortality may approach 50%. The time around labor and delivery is particularly dangerous, and the highest incidence/pregnancy or within 5 months of delivery. Patients with a prior history of myocardial disease are excluded from this definition. Risk factors include multiparity, being black, older maternal age, and preeclampsia. In a retrospective study of 123/

Ads by Google