434404
Congenital Heart Disease
- structural
defects
present from
birth
- more successful
surgical
treatments
- more survival to adulthood
- more survival to adulthood
- more successful
surgical
treatments
- Atrial or Ventricular Septal Defects
- Abnormal opening
between either right and
left atria or right and left
ventricle
- blood moves
through defect from
higher pressure on
left side to lower
pressure right
- extra blood may cause volume overload
- enlargement of right side
- heart failure
- aggravated by hypertension
- aggravated by hypertension
- over time can cause
overload of entire
pulmonary
vasculature
- develop
pulmonary
hypertension
- divert extra blood
volume away from the
lungs
- causes changes in the lungs which will increase pressure in the right side of the heart
- will reverse pressure gradient
- shunt will
reverse
- shunt will
reverse
- will reverse pressure gradient
- causes changes in the lungs which will increase pressure in the right side of the heart
- divert extra blood
volume away from the
lungs
- develop
pulmonary
hypertension
- heart failure
- enlargement of right side
- extra blood may cause volume overload
- blood moves
through defect from
higher pressure on
left side to lower
pressure right
- Abnormal opening
between either right and
left atria or right and left
ventricle
- Patent Ductus Arteriosis
- remnant of fetal life
- fetal circulation adapted to
bypass lungs
- temporary structure-
ductus arteriosus between
pulmonary artery and aorta
- rarely does not close after birth
- patent DA allows oxygenated blood to flow down
and pressure gradient from aorta to pulmonary
artery
- some of the oxygenated blood does not reach body
- pulmonary hypertension develops over time
- heart rate increases to move sufficient blood around body
- untreated? leads to heart failure
- untreated? leads to heart failure
- heart rate increases to move sufficient blood around body
- pulmonary hypertension develops over time
- some of the oxygenated blood does not reach body
- patent DA allows oxygenated blood to flow down
and pressure gradient from aorta to pulmonary
artery
- rarely does not close after birth
- temporary structure-
ductus arteriosus between
pulmonary artery and aorta
- fetal circulation adapted to
bypass lungs
- remnant of fetal life
- Pulmonary or Aortic Stenosis
- narrowing of pulmonary artery or
aorta as it leaves heart
- limits blood flow in either pulmonary or systemic system
- limits blood flow in either pulmonary or systemic system
- narrowing of pulmonary artery or
aorta as it leaves heart
- Eisenmenger's Syndrome
- Large left-right shunt of blood is
not corrected (ASD, VSD, PDA)
- Increase pulmonary blood flow
- fibrosis, pulmonary hypertension and cyanosis
- right heart pressure exceeds left and shunt
reverses worsening cyanosis
- advised against pregnancy. mortality 30-50%
- increased fetal prematurity
- increased fetal prematurity
- advised against pregnancy. mortality 30-50%
- right heart pressure exceeds left and shunt
reverses worsening cyanosis
- fibrosis, pulmonary hypertension and cyanosis
- Increase pulmonary blood flow
- Large left-right shunt of blood is
not corrected (ASD, VSD, PDA)
- Marfan's Syndrome
- autosomal dominant defect on
chromosome 15
- connective tissue
disease
- affects musculoskeletal, cardiovascular systems and eyes
- elastic fibres in the media of blood vessels weaken
- dilatation of ascending and descending aorta
- lead to dissection or rupture or both
- occurs at av. 32yrs
- premature death
- premature death
- occurs at av. 32yrs
- lead to dissection or rupture or both
- dilatation of ascending and descending aorta
- elastic fibres in the media of blood vessels weaken
- affects musculoskeletal, cardiovascular systems and eyes
- connective tissue
disease
- 50% chance of child
inheriting it if one parent is
affected
- couples carefully counselled if
affected before embarking on
pregnancy
- minimal cardiovascular involvement
and aortic root dimensions have
better outcomes
- careful monitoring req. throughout pregancy
- prophylactic antihypertensive treatment
with beta-blockers recommended
- prophylactic antihypertensive treatment
with beta-blockers recommended
- careful monitoring req. throughout pregancy
- minimal cardiovascular involvement
and aortic root dimensions have
better outcomes
- couples carefully counselled if
affected before embarking on
pregnancy
- autosomal dominant defect on
chromosome 15
- Fallot's Tetralogy
- 4 major defects
- VSD, Pulmonary Stenosis,
Overriding Aorta and Right
ventricular hypertrophy
- reduced oxygenation of blood
- life long follow up needed
- pulmonary valve may become leaky as heart grows.
- pulmonary valve may become leaky as heart grows.
- life long follow up needed
- reduced oxygenation of blood
- VSD, Pulmonary Stenosis,
Overriding Aorta and Right
ventricular hypertrophy
- 4 major defects
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