Congenital heart disease has a prevalence of 0.5-0.8% of live births. It can be caused by genetic and environmental factors. Defects are classified as acyanotic if there is increased blood flow to the lungs, or cyanotic if there is decreased pulmonary blood flow. Common defects include atrial septal defects, ventricular septal defects, and patent ductus arteriosus. Diagnosis involves tests like echocardiogram and chest x-ray. Treatment options include procedures to close defects, heart transplantation, open heart surgery, and medications to manage symptoms.

1. International Medical Faculty
NAME :- MOHIT RULANIYA
TOPIC :- CONGENITAL HEART DISEASE

3. Epidemiology
• Prevalence:0.5-0.8% of live births (8/1000).Leading cause
ofdeath in children with CHD.
• Etiology:Unknown,multifactorial inheritance,genetic factors
implicated,high incidence in first degree relatives.
• 3% have a single gene defect,13% have associated
chromosomal abnormalities.
• 2-4% are associated with environmental or maternal
conditions & teratogenic influences.
• Gender differences:ASD,VSD,PDA & Pulmonic stenosis more
common in girls,left sided lesions in boys.

6. Classification
• Acyanotic:
• according to the
predominant physiologic
load placed on the heart.
• Volume load:L-R shunts-
ASD,VSD,PDA.
• Pressure load:Ventricular
outflow obstruction
• Pulmonary,aortic valve
lesions,aortic coarctation &
pulmonary stenosis.

7. Cyanotic:
• based on pathophysiology.
• Decreased pulmonary
bloodflow:TOF,Pulmonary
atresia,Tricuspid atresia,Single
ventricle with pulmonic stenosis.
• Increased pulmonary blood
flow:Transposition of great
vessels,Truncus arteriosus.

9. ATRIAL SEPTAL DEFECT.
•Sinus venosus defect:high in the septum.
•Ostium secundum defect:midseptum.
•Ostium primum defect:low in the septum.
•Pathophysiology:L-R shunt-increased flow across Rt
heart-RV & PA enlargement.
•Clinical features:asymptomatic,slow wt
gain,frequent LRTI.
•Diagnosis:Rt ventricular heave,systolic
murmur,fixed wide split S2.

11. Investigations:
• CXR:enlarged heart & PA,increased vascularity.
• ECG:Rt axis in secundum defect,hallmark of primum defect is
extreme Lt axis,RVH.
• ECHO:RVH,valve anatomy,flow direction.
• Treatment:closure during cardiac cathetrization,surgical closure.

12. VENTRICULAR SEPTAL DEFECT.
•Most common CHD (26%),may be single or
multiple.
•Pathophysiology:Lt-Rt shunt as long as pulmonary
vascular resistance is lower than systemic
resistance,if reverse shunt reverses
•Large defects lead to pul.hypertension-
Eissenmenger syndrome.
•Clinical features: depend on
size,asymptomatic,growth failure,recurrent
LRTI,congestive heart failure,SOB,cyanosis
•Diagnosis:pansystolic murmur,loud p2.

14. Investigations
•CXR:cardiomegaly,enlarged LA&LV.
•ECG:extreme lt axis is charecteristic,biventricular
hypertrophy.
•ECHO:chamber size & pressures.
•Cardiac catheter:O2 content,PA pressure,size & no
of defects.
•Treatment:Endocarditis
prophylaxis,digoxin,diuretics.
•Surgical closure before pulmonary vascular changes
become irreversible.

15. PATENT DUCTUS ARTERIOSUS.
•Connection between PA & descending aorta
•10% of CHD.
•Pathophysiology:Lt-Rt shunt,reverses if pulmonary
resistance increases-RV enlargement.If PDA is large
Eissenmenger syndrome can develop.
•Clinical features:depend on size & direction of
flow,slow growth,LRTI,SOB,cyanosis.
•Diagnosis:bounding pulse,continous murmur,loud
S2.

16. Investigations
•CXR:cardiomegaly,increased pul vascularity.
•ECG:Lt or biventricular hypertrophy.
•ECHO:2D visualises PDA,doppler shows turbulance.
•Cardiac catheter:PA pressures & O2 sats.
•Treatment:Endocardial prophylaxis as long as
patent,Indomethacin.
•Surgical:ligation is curative.

17. TREATMENT
• Procedures using catheterization .
• Heart transplant
• OPen heart surgery
• Medications:Drugs known as angiotensin-converting enzyme (ACE)
inhibitors, angiotensin II receptor blockers (ARBs) and beta blockers
and medications that cause fluid loss (diuretics) can help ease stress
on the heart by lowering blood pressure, heart rate and the amount
of fluid in the chest.

18. Referance:-
• www.slideshare.com
• www.webmed.com
• www.Wikipedia.com