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Pedia

  1. 1. Congenital Heart Defects Defects with Increased Pulmonary Blood Flow
  2. 2. Atrial Septal Defect <ul><li>An abnormal connection between the R and L atria and is illustrated in the diagram. </li></ul><ul><li>Clinical Manifestations </li></ul><ul><li>- generally asymptomatic </li></ul><ul><li>- with soft systolic murmur </li></ul><ul><li>- more classically a widely split S2 unaffected by respiratory pattern. </li></ul>
  3. 3. <ul><li>Diagnostics </li></ul><ul><li>- presence of murmur </li></ul><ul><li>- CXR – cardiomegaly </li></ul><ul><li>- ECG - demonstrates size of defect. </li></ul><ul><li>- cardiac death is not routinely indicated for dx of a n isolated ASD. </li></ul><ul><li>Treatment </li></ul><ul><li>- preoperative interaction </li></ul><ul><li>- Diuretics </li></ul><ul><li>- surgical repair is performed in the preschool age. </li></ul><ul><li>- sternotomy </li></ul>
  4. 4. Ventricular Septal Defect <ul><li>Abnormal connection bet R. and L Ventricles. </li></ul><ul><li>Clinical Manifestations </li></ul><ul><li>- asymptomatic </li></ul><ul><li>- large defect – CHF </li></ul><ul><li>- tachypneic, diaphoretic, fatigues easily, underweight for age </li></ul><ul><li>- tires before feeding is completed. </li></ul>
  5. 5. <ul><li>Diagnostics </li></ul><ul><li>- loud holosystic murmur </li></ul><ul><li>- Normal CXR </li></ul><ul><li>- large defects (cardiomegaly, increased in pulmonary blood flow) </li></ul><ul><li>- ECG (shows size of defect) </li></ul>
  6. 6. Patent Ductus Arteriosus <ul><li>Direct connection between the main pulmonary artery and the aorta. </li></ul><ul><li>Term newborn – the ductus closes within 12 hours and should be closed by 2-3 weeks. </li></ul><ul><li>s/s </li></ul><ul><li>- if small : asymptomatic </li></ul><ul><li>- if large : CHF </li></ul>
  7. 7. Atrioventricular Septal Defects <ul><li>Asso. With septal defects in the atrium and ventricle as well as involvement of the AV Valves. </li></ul><ul><li>s/s: </li></ul><ul><li>- s/s of CHF </li></ul><ul><li>- with murmur </li></ul><ul><li>- virtually all are asymptomatic </li></ul>
  8. 8. Truncus Arteriosus <ul><li>Single arterial trunk arises from the heart. </li></ul><ul><li>s/s: </li></ul><ul><li>- cyanosis </li></ul><ul><li>- w/ s/s of CHF </li></ul><ul><li>- with loud continuous murmur </li></ul><ul><li>- symptoms always develop in the 1 st month of life. </li></ul>
  9. 9. Defects with decrease Pulmonary Blood Flow <ul><li>Pulmonary Stenosis </li></ul><ul><li>- refers to narrowing of the pulmonary valve and obstruction to blood flow from the R ventricle to the lungs. </li></ul><ul><li>- s/s : </li></ul><ul><li>- mild to moderate – asymptomatic with mumur </li></ul><ul><li>- normal growth </li></ul><ul><li>- dyspneas, cyanosis </li></ul>
  10. 10. Tetralogy of Fallot <ul><li>Made up of VSD, PS and R Ventricular hypertrophy, overriding aorta </li></ul><ul><li>s/s: </li></ul><ul><li>- TET spells </li></ul><ul><li>- cyanosis </li></ul><ul><li>- hyperpnea </li></ul>
  11. 11. Transposition of the Great Aorta <ul><li>The aorta and the pulmonary artery is transposed or reversed. </li></ul>
  12. 12. Tricuspid Atresia <ul><li>Characterized by absence of or complete closure of the tricuspid valve and therefore no connection bet the RA and the RV. </li></ul><ul><li>Includes ASD, VSD, and varying degrees of RV hypoplasia. </li></ul><ul><li>Maybe due to underdeveloped / incomplete development. </li></ul>

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