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Congenital heart disease 2021
This document discusses congenital heart disease, including its classification, epidemiology, etiology, and clinical features. Congenital heart defects are classified as cyanotic or acyanotic. Cyanotic defects include tetralogy of Fallot and transposition of the great arteries, which allow deoxygenated blood to mix with oxygenated blood. Acyanotic defects allow oxygenated blood to shunt left-to-right, such as ventricular septal defects, atrial septal defects, and patent ductus arteriosus. Obstructive lesions include aortic and pulmonary stenosis. Congenital heart disease has an incidence of 8 per 1000 live births. Clinical features may include cyanosis, heart murmurs, heart failure symptoms
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Congenital heart disease 2021
- 1. Congenital Heart Disease Classification,Epidemiology, Etiology Clinical Features Prof. Imran Iqbal Fellowship in Pediatric Neurology (Australia) Prof of Paediatrics (2003-2018) Prof of Pediatrics Emeritus, CHICH Prof of Pediatrics, CIMS Multan, Pakistan
- 2. Al Quran surahQaf 50:37
- 3. Congenital Heart Disease- Classification • Cyanotic Congenital Heart Disease (R to L shunts) • Tetralogy of Fallot (TOF) • Transposition of the Great Arteries (TGA) • Acyanotic Congenital Heart Disease • L to R shunts Ventricular Septal Defect (VSD) Atrial Septal Defect (ASD) Patent Ductus Arteriosus (PDA) • Obstructive lesions Aortic Stenosis (AS) Pulmonary Stenosis (PS)
- 4. Congenital Heart Disease- Epidemiology • Congenital Heart Disease (CHD) – • Incidence - 8 per 1000 live births
- 5. Acyanotic Congenital HeartDefects (Relative Frequency) • Ventricular Septal Defect (25% of total Congenital Heart Defects) • Atrial Septal Defect (7%) • Patent Ductus Arteriosus (12%) • Co-arctation of Aorta (5%) • Aortic Stenosis (5%) • Pulmonary Stenosis (5%)
- 6. Cyanotic Congenital HeartDefects (Relative Frequency) • Tetralogy of Fallot (10% of total Congenital Heart Defects) • Transposition of the Great Arteries - TGA (7% of total Congenital Heart Defects) • Rare Cyanotic Defects – • Total Anomalous Pulmonary Venous Drainage • Tricuspid Atresia • Pulmonary Atresia
- 7. Congenital Heart Disease- Etiology • Genetic Factors • Genetics – Gene mutations (NOTCH gene) • Chromosomal / Genetic Syndromes – Turner syndrome, Down syndrome • Environmental Factors • Maternal Viral Infections – Rubella in pregnancy • Maternal medications – sodium valproate • Maternal diseases - Diabetes
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- 9. Examination of CardiovascularSystem • Dysmorphic features (GPE) • Color (Cyanosis – on lips, tongue, hands, nails) • Respiratory rate and effort • Heart rate and rhythm • Heart sounds and murmurs • Pulse (rate, rhythm, volume, peripheral pulses) • Inspection of precordium • Palpation of apex beat • Palpation for thrills and heave
- 10. CVS - AbnormalSymptoms • Bluish discoloration • Poor feeding • Sweating on feeding • Respiratory distress on feeding • Swelling of face • Palpitation
- 11. CVS – AbnormalSigns • Cyanosis • Tachypnoea • Poorly palpable or absent peripheral pulses • Hyper-dynamic precordium • Displaced apex beat • Thrill or heave present • Abnormal cardiac rate or rhythm • Added heart sounds or murmurs • Hepatomegaly
- 12. Clinical features of CongenitalHeart Disease • Cyanosis, Clubbing (Cyanotic Heart Disease) • Heart murmur (child may be asymtomatic) • Heart failure (tachypnea, tachycardia, hepatomegaly) • 50 % of Congenital Heart Disease patients are symptomatic • 50 % are initially asymptomatic
- 13. Differentiate between Valvular lesionsand Flow Murmurs • Innocent (flow murmurs) have following features • Short systolic murmurs • Left lower sternal border • No radiation • Low intensity, not loud • Soft not harsh • Commonly associated with Anemia
- 14. Heart Murmurs andDiagnosis
- 15. Congenital Heart Disease- Classification • Cyanotic Congenital Heart Disease (R to L shunts) • Tetralogy of Fallot (TOF) • Transposition of the Great Arteries (TGA) • Acyanotic Congenital Heart Disease • L to R shunts Ventricular Septal Defect (VSD) Atrial Septal Defect (ASD) Patent Ductus Arteriosus (PDA) • Obstructive lesions Aortic Stenosis (AS) Pulmonary Stenosis (PS)
- 16. Congenital Heart Disease- Classification