Congenital Heart defects

1. P R E PAR E D B Y: R AJ A L A K S H M I . S
CONGENITAL HEART
DEFECTS

4. INTRODUCTION
• Congenital heart defects are one of the most common
congenital anomalies that may involve chambers, valves,
great vessels arising from the heart. Most of the cases
case is unknown.

6. ATRIAL SEPTAL DEFECT

11. PATENT DUCTUS ARTERIOSUS

13. INCIDENCE
• One of the most common defect of the heart
• It is twice more common in females as compared to
males.
• PDA is common in infants who weigh less than 1500gm
and accounts for 5- 10 % of all congenital heart disease.

14. PATHOPHYSIOLOGY
Volume overloaded left ventricles
Increased blood return to left side of heart
Increased blood flow to pulmonary tree
Shunting of blood from high pressure aorta to low pressure
pulmonary artery
Failure of closure of ductus arteriosus

15. CLINICAL FEATURES
• Clinical features of PDA depend on the size of PDA and
age of infant.
• Preterm infants are usually symptomatic earlier.
• In preterm infants pulmonary vascular resistance falls
more rapidly, allowing more left to right shunting and
their myocardium is immature and less able to handle
the extra load so they go into congestive heart failure
easily.

16. • In term infants symptoms depend on the size of ductus.
• The term infants with small PDA are usually
asymptomatic, whereas those with large PDA may
present with congestive heart failure.
• These children may have growth retardation and easily
fatigability.

17. DIAGNOSTIC EVALUATION
• Cardiac examination
• Electrocardiogram
• Chest radiographs
• Echocardiogram

18. THERAPEUTIC MANAGEMENT
• Some PDA will close spontaneously; however preterm
infants who are symptomatic and require increasing
ventilatory support need early intervention either medical
or surgical.
• Medical managemnt
• Indomethacin
• Prostaglandin inhibitor
• Surgical management
• Thorough lateral thoracotomy
• Ductus is either ligated with suture or ligated and divided
completetly.

20. TETRALOGY OF FALLOT

21. • Tetralogy of fallot is the most complex congenital heart
defect with decreased pulmonary blood flow. It includes
a combination of 4 defects:
I. ventricular septal defect
II. Overridding of aorta
III. Pulmonary stenosis
IV. Right ventricular hypertrophy

23. TOF

25. CLINICAL FEATURES
• Cyanosis
• Clubbing of finger and toe nails occur by 1- 2 years of
age
• Exercise causes dyspnea
• Children assume ‘squatting position’ in between play, as
this position relieves dyspnea.
• Paroxysmal dyspneic attacks
• These children grow and develop normally
• They are small and their nutritional status is poor.

27. DIAGNOSTIC EVALUATION
• Cardiac examination
• Electrocardiogram
• Chest radiographs
• Echocardiogram
• Cardiac catheterization

29. THERAPEUTIC MANAGEMENT
Medical management
• Knee chest position
• Propranolol
• Intravenous prostaglandin E 1 therapy

31. Surgical management
a) Palliative surgery
a) Blalock –Taussing Shunt
b) Pott’s Procedure
c) Waterston Shunt
d) Brock’s Procedure

34. COMPLETE D-
TRANSPOSITION OF GREAT
ARTERIES

37. Arterial switch procedure

38. Senning procedure

40. Mustard repair

41. RHEUMATIC FEVER

42. Pathophysiology

45. RHEUMATIC HEART
DISEASE