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P R E PAR E D B Y: R AJ A L A K S H M I . S
CONGENITAL HEART
DEFECTS
INTRODUCTION
• Congenital heart defects are one of the most common
congenital anomalies that may involve chambers, valves,
great vessels arising from the heart. Most of the cases
case is unknown.
ATRIAL SEPTAL DEFECT
PATENT DUCTUS ARTERIOSUS
INCIDENCE
• One of the most common defect of the heart
• It is twice more common in females as compared to
males.
• PDA is common in infants who weigh less than 1500gm
and accounts for 5- 10 % of all congenital heart disease.
PATHOPHYSIOLOGY
Volume overloaded left ventricles
Increased blood return to left side of heart
Increased blood flow to pulmonary tree
Shunting of blood from high pressure aorta to low pressure
pulmonary artery
Failure of closure of ductus arteriosus
CLINICAL FEATURES
• Clinical features of PDA depend on the size of PDA and
age of infant.
• Preterm infants are usually symptomatic earlier.
• In preterm infants pulmonary vascular resistance falls
more rapidly, allowing more left to right shunting and
their myocardium is immature and less able to handle
the extra load so they go into congestive heart failure
easily.
• In term infants symptoms depend on the size of ductus.
• The term infants with small PDA are usually
asymptomatic, whereas those with large PDA may
present with congestive heart failure.
• These children may have growth retardation and easily
fatigability.
DIAGNOSTIC EVALUATION
• Cardiac examination
• Electrocardiogram
• Chest radiographs
• Echocardiogram
THERAPEUTIC MANAGEMENT
• Some PDA will close spontaneously; however preterm
infants who are symptomatic and require increasing
ventilatory support need early intervention either medical
or surgical.
• Medical managemnt
• Indomethacin
• Prostaglandin inhibitor
• Surgical management
• Thorough lateral thoracotomy
• Ductus is either ligated with suture or ligated and divided
completetly.
TETRALOGY OF FALLOT
• Tetralogy of fallot is the most complex congenital heart
defect with decreased pulmonary blood flow. It includes
a combination of 4 defects:
I. ventricular septal defect
II. Overridding of aorta
III. Pulmonary stenosis
IV. Right ventricular hypertrophy
TOF
CLINICAL FEATURES
• Cyanosis
• Clubbing of finger and toe nails occur by 1- 2 years of
age
• Exercise causes dyspnea
• Children assume ‘squatting position’ in between play, as
this position relieves dyspnea.
• Paroxysmal dyspneic attacks
• These children grow and develop normally
• They are small and their nutritional status is poor.
DIAGNOSTIC EVALUATION
• Cardiac examination
• Electrocardiogram
• Chest radiographs
• Echocardiogram
• Cardiac catheterization
THERAPEUTIC MANAGEMENT
Medical management
• Knee chest position
• Propranolol
• Intravenous prostaglandin E 1 therapy
Surgical management
a) Palliative surgery
a) Blalock –Taussing Shunt
b) Pott’s Procedure
c) Waterston Shunt
d) Brock’s Procedure
COMPLETE D-
TRANSPOSITION OF GREAT
ARTERIES
Arterial switch procedure
Senning procedure
Mustard repair
RHEUMATIC FEVER
Pathophysiology
RHEUMATIC HEART
DISEASE
congenital Heart Defects.PDA,ASD,VSD,TGApptx

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congenital Heart Defects.PDA,ASD,VSD,TGApptx

  • 1. P R E PAR E D B Y: R AJ A L A K S H M I . S CONGENITAL HEART DEFECTS
  • 2.
  • 3.
  • 4. INTRODUCTION • Congenital heart defects are one of the most common congenital anomalies that may involve chambers, valves, great vessels arising from the heart. Most of the cases case is unknown.
  • 5.
  • 7.
  • 8.
  • 9.
  • 10.
  • 12.
  • 13. INCIDENCE • One of the most common defect of the heart • It is twice more common in females as compared to males. • PDA is common in infants who weigh less than 1500gm and accounts for 5- 10 % of all congenital heart disease.
  • 14. PATHOPHYSIOLOGY Volume overloaded left ventricles Increased blood return to left side of heart Increased blood flow to pulmonary tree Shunting of blood from high pressure aorta to low pressure pulmonary artery Failure of closure of ductus arteriosus
  • 15. CLINICAL FEATURES • Clinical features of PDA depend on the size of PDA and age of infant. • Preterm infants are usually symptomatic earlier. • In preterm infants pulmonary vascular resistance falls more rapidly, allowing more left to right shunting and their myocardium is immature and less able to handle the extra load so they go into congestive heart failure easily.
  • 16. • In term infants symptoms depend on the size of ductus. • The term infants with small PDA are usually asymptomatic, whereas those with large PDA may present with congestive heart failure. • These children may have growth retardation and easily fatigability.
  • 17. DIAGNOSTIC EVALUATION • Cardiac examination • Electrocardiogram • Chest radiographs • Echocardiogram
  • 18. THERAPEUTIC MANAGEMENT • Some PDA will close spontaneously; however preterm infants who are symptomatic and require increasing ventilatory support need early intervention either medical or surgical. • Medical managemnt • Indomethacin • Prostaglandin inhibitor • Surgical management • Thorough lateral thoracotomy • Ductus is either ligated with suture or ligated and divided completetly.
  • 19.
  • 21. • Tetralogy of fallot is the most complex congenital heart defect with decreased pulmonary blood flow. It includes a combination of 4 defects: I. ventricular septal defect II. Overridding of aorta III. Pulmonary stenosis IV. Right ventricular hypertrophy
  • 22.
  • 23. TOF
  • 24.
  • 25. CLINICAL FEATURES • Cyanosis • Clubbing of finger and toe nails occur by 1- 2 years of age • Exercise causes dyspnea • Children assume ‘squatting position’ in between play, as this position relieves dyspnea. • Paroxysmal dyspneic attacks • These children grow and develop normally • They are small and their nutritional status is poor.
  • 26.
  • 27. DIAGNOSTIC EVALUATION • Cardiac examination • Electrocardiogram • Chest radiographs • Echocardiogram • Cardiac catheterization
  • 28.
  • 29. THERAPEUTIC MANAGEMENT Medical management • Knee chest position • Propranolol • Intravenous prostaglandin E 1 therapy
  • 30.
  • 31. Surgical management a) Palliative surgery a) Blalock –Taussing Shunt b) Pott’s Procedure c) Waterston Shunt d) Brock’s Procedure
  • 32.
  • 33.
  • 35.
  • 36.
  • 39.
  • 43.
  • 44.