SANCHEZ, ANGELICA G.

BSN 2
CONGENITAL HEART
DISORDER

1. Ventricular Septal
Defect

2. Atrial Septal Defect

3. Atrioventricular
Canal Defect
(Endocardial Cushion
Defect)
4. Patent Ductus
Arteriosus

DESCRIPTION
An opening is present in the septum between the two ventricles. Because pressure in
the left ventricle is greater than that in the right ventricle, blood shunts from left to
right across the septum
Blood that should go into the aorta and out to the body is shunted back to the right
ventricle and into the pulmonary circulation.
Resulting to right ventricular hypertrophy and increased pressure in the pulmonary
artery
NOT EVIDENT AT BIRTH: high pulmonary resistance
4-8 wks infant demonstrates fatigue and loud, harsh pansystolic murmur becomes
evident along the left sternal border at the 3 rd or 4th interspaces, thrills may also be
palpable
Abnormal communication between the two atria, allowing blood to shift from the left to
the right atrium. Blood flow from left to right due to the stronger contraction the left
side of the heart
Increased volume in the right side of the heart and results in ventricular
hypertrophy and increased pulmonary artery blood flow
Two types of ASD:
a. Ostium Primum (ASD1): opening is at the lower end of the septum
b. Ostium Secundum (ASD2): opening is near the center of the septum, maybe
asymptomatic and not discovered until infection from recirculating blood
occurs
More common in girls than boys, heart sound will be auscultated as split (Fixed
splitting)
Usually there is low ASD continuous with high VSD and distortion of the mitral and
tricuspid valves
Leads to the same symptoms as ASDs: right ventricular hypertrophy, increased
pulmonary blood flow, fixed S2 splitting
Rare in the general population but 50% of children with trisomy 21 who have heart
disease have this
The ductus arteriosus fails to close at birth (closure begins with the first breath, and is
usually complete between 7-14 days of age, although full closure may not occur until 3
mos of age)
Blood will shunt from the aorta (oxygenated blood) to the pulmonary artery
(deoxygenated blood) because of the increased pressure in the aorta

CLASSIFICATI
ONS:

Increased
Pulmonary
Blood Flow
and Acyanotic
Disorder

Increased
Pulmonary
Blood Flow
and Acyanotic
Disorder

Increased
Pulmonary
Blood Flow
and Acyanotic
Disorder
Increased
Pulmonary
Blood Flow
and Acyanotic
Disorder

5. Pulmonary Stenosis

6. Aortic Stenosis

7. Aortic Coarctation

8. Transposition of the
Great Arteries

Increased pressure in the pulmonary circulation leads to right ventricle hypertrophy

Twice as common in girls as boys and occurs at higher altitude
Child has a wide pulse pressure with the diastolic pressure low with a typical
continuous machinery murmur heard at the upper left sternal border or under the
clavicle.
*** Ductus Arteriosus is an accessory fetal structure that connects the pulmonary
artery to the aorta
Narrowing of the pulmonary valve or the pulmonary artery just distal to the valve and
results to:
Inability of the right ventricle to evacuate blood by way of the pulmonary artery and
leads to right ventricular hypertrophy
Infants with this disorder may be asymptomatic or with mild (right-sided) heart
failure
If narrowing is sever cyanosis may be present
Stenosis or stricture of the aortic valve prevents blood from passing freely from the left
ventricle of the heart into the aorta resulting to:
Increased pressure and hypertrophy of the left ventricle
Pressure in the left atrium also increases resulting to back pressure into the
pulmonary vein and possibly pulmonary edema
Most cases in children are asymptomatic. Upon physical examination a rough
systolic sound is heard loudest in the second right interspace that may be
transmitted to the right shoulder, clavicle, and up to the vessels of the neck and to
the hearts apex
Thrills may be present along the suprasternal notch, hypotension, tachycardia
inability to suck for long periods, when active chest pain similar to angina is felt
Narrowing of the lumen of the aorta due to a constricting band, that leads to
congestive heart failure in the first few months of life
Two locations: Preductal- constriction b/n subclavian artery and ductus arteriosus
Postductal- constriction is distal to the ductus arteriosus
Blood pressure increases proximal to the coarctation and decreases distal to it
Elevated upper-body blood pressure that produces headache and vertigo
Exceptional irritability, epistaxis, cerebrovascular accident
Slight absence of palpable femoral pulse the only symptom
Aorta arises from the right ventricle instead of the left, and pulmonary artery arises
from the left ventricle instead of the right therefore:
completely deoxygenated blood travels directly into the aorta and then throughout
the body
the second source of blood enters the heart from the pulmonary veins, goes to the
left atrium, left ventricle and out to the pulmonary arteries to be oxygenated

Obstruction to
Blood Flow
and Acyanotic
Disorder

Obstruction to
Blood Flow
and Acyanotic
Disorder

Obstruction to
Blood Flow
and Acyanotic
Disorder

Disorders
with Mixed
Blood Flow
and Cyanotic
Disorder

9. Total Anomalous
Pulmonary

10.Truncus Arteriosus

11.Hypoplastic Left
Heart Syndrome

12.Tricuspid Atresia

13.Tetralogy of Fallot

infants with this condition are cyanotic, enlarged heart seen to ECG
Pulmonary veins return to the right atrium or the superior vena cava instead of the left
atrium as they normally would. For blood to reach the systemic circulation, it must
shunt across the patent foramen ovale; an absent spleen is usually associated to this
disorder,
Infants are mildly cyanotic and they tire easily
A rare defect where, one major artery or trunk arises from the left and right ventricles
in place of separate aorta or pulmonary artery
Usually accompanied by VSD, child is cyanotic and may have a typical VSD murmur

A rare disorder where the left ventricle is nonfunctional. The nonfunctioning left
ventricle lacks adequate strength to pump blood in to the systemic circulation. May be
accompanied by mitral or aortic valve atresia. This disorder leads to right ventricle
hypertrophy
At birth, mild to moderate cyanosis as deoxygenated blood is shunted across the
foramen ovale because of the greater pressure on the right
Tricuspid valve is completely closed, allowing no blood to flow from the right atrium to
the right ventricle. Instead, blood crosses through the patent foramen ovale into the left
atrium, bypassing the lungs and the step oxygenation. It only reaches the lungs for
oxygenation by being shunted to the PDA. At the point the PDA and FO close the infant
develops extreme cyanosis, tachycardia, dyspnea
It is called tetralogy because four anomalies are present: pulmonary stenosis, VSD
(usually large), dextroposition (overriding) of the aorta, and hypertrophy of the right
ventricle. Because of the pulmonary stenosis, pressure builds up in the right side of the
heart. Blood then shunts from this area of increased pressure into the left ventricle and
overriding aorta. The extra effort involved to force blood through the stenosed
pulmonary artery causes the fourth deformity, hypertrophy of the right ventricle

Disorders
with Mixed
Blood Flow
and Cyanotic
Disorder
Disorders
with Mixed
Blood Flow
and Cyanotic
Disorder
Disorders
with Mixed
Blood Flow
and Cyanotic
Disorder
Disorder with
Decreased
Pulmonary
Blood Flow
and Cyanosis
Disorder
Disorder with
Decreased
Pulmonary
Blood Flow
and Cyanosis
Disorder