VII.

Pathophysiology

Maternal Factors Genetic Factors

Congenital defect in the heart

Left to right shunting

Increased left ventricular volume load

Excessive pulmonary blood flow Increased pulmonary interstitial fluid

Reduced systemic cardiac output

Oxygenated blood enters pulmonary artery

Increased catecholamine secretion and salt and water retention

Increase blood flow to the lungs Increase pulmonary venous return to LA and ultimately LV LV dilation and Hypertrophy

Pulmonary edema PA pressure and pulmonary venous pressure are elevated Signs of Congestive heart failure Failure to thrive

Pulmonary hypertension LA pressure decreased murmur Tachypnea

Increase end diastolic pressure and LA pressure Raise in pulmonary venous pressure

Difficulty of weight gain