Professional Documents
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Shenzhou Hospital
He Lihui
Overview
Congenital heart defects are abnormalities in the heart's structure that are present at birth.
Approximately 8 out of every 1,000 newborns have congenital heart defects, ranging from mild to severe.
Etiology
1.Genetic factor (internalfactor) chromosomal aberrations :Genetic and
2. Environmental factor (external factor): High altitude 3. Other related factors: Viral infections of pregnancy , Mothers who are diabetic, alcoholics or drug addictive Drugs and metabolic factors
4. Inherited factor
Prevention
The health protection of pregnant woman should be enhanced. High risk factors, such as drugs, radiation, viral infection, et.should be avoided. Suit dosage Folic Acid should be filled up in early pregnancy stage.
CHD
Acyanotic CHD
Cyanotic CHD
Obstructive lesions Pulmonic stenosis Aortic stenosis Coarctation of aorta Mitral regurgitation
R to L shunts
TOF Complete TGA
Pulmonary arterial hypertention (hyperkineticobstructive) Persistent cyanosis in late stage (Eissenmagers syndrome)
Definition:
ASD is an abnormal communication between the two atria.
Classification:
Ostium secundum type
ASD
Accounts about 5%~10% of all CHD cases.
The incidence is estimated to be 1 per 1500 live births. Is the most common CHD in adult.
Male : Female 1: 2
PV
SVC
RA AO
PV LA
PA LV
IVC RV
ASD murmu r
Size of the ASD lesion Pressure difference between two atria RV diastolic accommodation
Hemodymamics of ASD
Oxygenated blood in PVs LA ASD shunting SVC IVC RA enlargement
RV enlargement
PA congestive
Obstructive PAH
Eisenmangers syndrome
Pulmonary Vein
Failure To Thrive
Obstructive PA Hypertension
Cyanosis Eisenmangers Syndrome
Generally asymptomatic
Pulmonary plethoric: frequent chest infections Systemic Circulation InsufficiencyFailure to thrivepoor weight gainfeeding difficulty fatigue shortness of breathesweating CyanosisSevere cyanosis in large lesions softer heart murmur and accentuated P2.
sound: S1 accentuated - loud S2 widely split and fixed( Volume in RV Prolonged ejection phase-Pul.Valve closes late P2 accentuated Murmurs Shunt Murmur: Absent Flow Murmurs: (a) A grade -/ ejection systolic murmur is heard best at LSB2-3 which widely transmitted all over the chest. No thrill. (relative Pul. Valve stenosis)
(b) Delayed Diastolic Murmur at LLSB ( relative Tricuspid sterno
Sign of ASD
Complication of ASD
ECG of ASD
Right Ventricle HypertrophyRVH) Right Axis Deviation Incompleted right bundle branch block (IRBBB)I0
X-ray findings
Plethoric Lung fields RA and RV enlargement Prominent PA segment Normal or small aortic shadow
USG findings
RA , RV enlargement RV overloaded Parallel shunt between atria in Doppler
Catheterization
1SaO2 in RAin Vena Cava 2Pressure of RV and PA is mormal or mildly 3Catheter passing through the lesion can enter RV from RA.