Congenital Heart Disease Dr. Raid Jastania

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

Left-to-Right Shunt

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

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

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

                                                    

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

                                                    

Patent ductus arteriosus

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

                                                    

Right-to-Left shunt

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

                                                    

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

                                                    

Obstructive Defect

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