Child health

1. CardioVascular Diseases
Ms. K. Lavanya
MSc(N)-CHN
Associate Professor

2. Introduction:
 Cardiovascular diseases are uncommon in childhood.
 The major problems seen include congenital heart disease (usually abnormalities of
the great vessels, Hypo plastic heart, pulmonary or aortic atresia and Tetralogy of
Fallot), Cardiac failure, rheumatic fever carditis and myocarditis.
 Functional or innocent heart murmurs are common.
 Congestive heart failure at birth is rare and usually suggests severe valvular
deformities.
 Symptoms of ventricular septal defect including heart failure, usually occur at
approximately six weeks of age.

3. Congenital Heart Defects:
1. Congenital means present at birth.
2. Congenital heart defects are heart conditions that a baby is born with.
3. CHD are the most common types of birth defects. They may affect the shape
of a baby’s heart; the way it works or both.
4.Heart defects can affect the baby’s blood flow causing blood to: slow down,
go in the wrong direction or to the wrong place, be blocked completely.
5. There are different types of congenital heart defects; they can be divided into
three main categories; heart valve defects, heart wall defects, blood vessel
defects.

4. Etiology:
• Medications: Certain medications taken during pregnancy may cause birth defects,
including congenital heart defects.
 Medications known to increase the risk of congenital heart defects include
thalidomide (Thalomid), Angiotensin-Converting Enzyme (ACE) inhibitors, stains,
the acne medication isotretinoin (Absorica, Amnesteem, Clavaris) and lithium.
 Drinking alcohol during pregnancy: Increases the risk of congenital
heart defects.
 Smoking: During pregnancy increases the likelihood of a congenital heart
defect in the baby.

5. Contd…
 Diabetes: Increases blood sugar levels, such as occurs with diabetes, may
affect childhood development.
 Rubella (German Measles): Having rubella during pregnancy can cause
problems in baby’s heart development.
• Heredity: Congenital heart defects sometimes run in families and may be
associated with a genetic syndrome.
• Problems with genes or chromosomes in the child such as down’s syndrome.

6. Types of Congenital Heart Defects:
 Congenital heart defects are either cyanotic or acyanotic.
 In both types, the heart is not pumping blood efficiently
 The main difference is that cyanotic congenital heart defects causes low
levels of oxygen in the blood and acyanotic congenital heart defect does not.
 Babies with reduced oxygen levels may experience breathlessness and a
bluish tint to their skin.
 Babies who have enough oxygen in their blood do not display these
symptoms, but they may still develop complications later in life, such as high
blood pressure.

7. Cyanotic Heart Defects:
1.Cyanotic heart defects are congenital cardiac malformations that commonly affect
the atrial or ventricular walls, heart valves or large blood vessels.
2. Cyanotic defects are defects in which blood pumped to the body contains less-than-
normal amounts of oxygen.
3. It is indicated by a bluish tint to the skin called cyanosis.
4. Infants with cyanosis are often called blue babies.
5. Cyanotic heart defects by their physiology (i.e., right-to- left shunting,
inadequate pulmonary blood flow (PBF) or common mixing lesions), many
defects have multiple physiologic abnormalities.

8. Contd….
Blue cyanosis only visible when hemoglobin is more than 5 gm/dl.
The classic mnemonic, the “five T’s” of cyanotic congenital heart diseases are:
Tetralogy of Fallot
Tricuspid Atresia
Transportation of great arteries (TGA)
Truncus Arteriosus
Total Anomalous pulmonary venous connection (TAPVC)

9. Acyanotic heart defects:
1. Acyanotic heart defects are characterized pathophysiologically by a left- to-right shunt,
which causes pulmonary hypertension and right heart hypertrophy.
2. These defects cause the heart to function ineffectively and make the child prone to heart
failure. The most common defects in this group are:
a. Atrial septal defect (ASD)
b. Ventricular septal defect (VSD)
c. Patent ductus arteriosus (PDA)
d. Aortic stenosis
e. Pulmonary stenosis
f. Coarctation of Aorta