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Congenital structural heart defects.
- 1. Congenital Heart Defects By: Mohammed H. Supervised by Asst. Prof. Dr. Kawes zangana 1
- 2. OUTLINES Overview Fetal VS neonatal circulation Etiology How to approach Evaluation and Classification 2
- 3. OVERVIEW CHDisease occurs in 0.8% of live births. (3-4%) stillborns, (10-25%) spontaneous abortuses, and 2% premature infants. CHD remains the leading cause of death in children with congenital malformations. 3
- 4. CLASSIFICATION OF CHD Structural heart defects Cardiomyopathies Arrhythmias >> Is a gross structural abnormality of the heart or intrathoracic great vessels 4
- 5. Fetal VS normal circulation 5
- 6. ETIOLOGY **Unknown Multifactorial and result from a combination of genetic predisposition and an as- yet-to-be-determined environmental stimulus Chromosomal abnormalities Adverse maternal conditions Gender Race 6
- 7. APPROACH to CHD History: Physical Examination: General Inspection: Upper Limbs Head and Neck Chest Abdomen Lower Limbs History of poor feeding, sweating, poor weight gain, exercise intolerance, respiratory distress, cyanosis Family history of CHD Maternal history of diseases, drug intake, alcohol 7
- 8. Evaluation and CLASSIFICATION Involves 3 major components: 1- Presence or absence of Cyanosis 2- Chest roentgenogram 3- Electrocardiogram increased pulmonary vascular markings: normal, decreased Right VENTRICULAR Left VENTRICULAR Hypertrophy Biventricular 8
- 9. Acyanotic Cyanotic Increased PBF Normal PBF RVH LVH RVH LVH ASD PAPVR PS MS VSD PDA AVSD AS COA 9
- 10. Acyanotic Cyanotic Decreased PBF Increased PBF RVH LVH RVH BVH TOF PA/VSD DORV/PS TGA/VSD/PS TGA TAPVR DORV HLHS Tricuspid atresia PA/IVS Truncus Arteriosus 10
- 11. CLASSIFICATION cont’d. *Murmur The final diagnosis is then confirmed by echocardiography, CT or MRI, or cardiac catheterization. 11
- 12. REFERENCES: 1-Nelson textbook of pediatrics 20th edition 2-Friedman WF, et al. “Congenital Heart Disease in Infancy and Childhood”, In Heart Disease A Textbook of Cardiovascular Medicine..6th ed. Ed By Braunwald et al.WB Saunders Company Philadelphia London New York StLouis Sydney Toronto. 2001:1505-91. 3- Oxford handbook of pediatrics 4- manual of neonatal care 5-Pediatric review 12