Congenital heart defects are abnormalities in the heart's structure that are present at birth. They can affect the heart's chambers, valves, or blood vessels. Common defects include ventricular septal defects (holes in the wall between the ventricles), atrial septal defects, patent ductus arteriosus, tetralogy of Fallot, and transposition of the great arteries. Many defects cause no symptoms, but some can lead to heart failure, lung problems, or other serious issues if not treated with medication, catheterization, or surgery. Diagnosis involves medical history, physical exam, chest X-ray, electrocardiogram, and echocardiogram.
Congenital heart disease is a general term for a range of birth defects that affect the normal way the heart works. The term "congenital" means the condition is present from birth.
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries.
Some babies with tricuspid atresia have other conditions, such as pulmonary stenosis or transposition of the great arteries, that also affect blood flow through their heart. These conditions require treatment, too.
Congenital heart disease is a general term for a range of birth defects that affect the normal way the heart works. The term "congenital" means the condition is present from birth.
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries.
Some babies with tricuspid atresia have other conditions, such as pulmonary stenosis or transposition of the great arteries, that also affect blood flow through their heart. These conditions require treatment, too.
ACYANOTIC DISEASE- Non cyanotic heart diseasesNelsonNgulube
ETIOLOGY AND EPIDEMIOLOGY
Congenital heart disease occurs in 8 per 1,000 births. The spectrum of lesions ranges from asymptomatic to fatal. Although most cases of congenital heart disease are multifactorial, some lesions are associated with chromosomal disorders, single gene defects, teratogens, or maternal metabolic disease (see Table139-2).
Congenital heart defects can be divided into three pathophysiological groups (Table 143.1).
1. Left-to-right shunts
2. Right-to-left shunts
3. Obstructive, stenotic lesions
Acyanotic congenital heart disease includes left-to-right shunts resulting in an increase in pulmonary blood flow (patent ductus arteriosus [PDA], ventricular septal defect [VSD], atrial septal defect [ASD]) and obstructive lesions (aortic stenosis, pulmonary stenosis, coarctation of the aorta), which usually have normal pulmonary blood flow.
VENTRICULAR SEPTAL DEFECTEtiology and Epidemiology
The ventricular septum is a complex structure that can be divided
into four components. The largest component is the muscular
septum. The inlet or posterior septum comprises endocardial
cushion tissue. The subarterial or supracristal septum com
prises conotruncal tissue. The membranous septum is below
the aortic valve and is relatively small. VSDs occur when any of these components fail to develop normally (Fig. 143.1). VSD,
the most common congenital heart defect, accounts for 25% of all congenital heart disease. Perimembranous VSD
A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.
Doctors use a physical exam and special heart tests to diagnose congenital heart defects. They often find severe defects during pregnancy or soon after birth. Signs and symptoms of severe defects in newborns include
Rapid breathing
Cyanosis - a bluish tint to the skin, lips, and fingernails
Fatigue
Poor blood circulation
Many congenital heart defects cause few or no signs and symptoms. They are often not diagnosed until children are older.
Many children with congenital heart defects don't need treatment, but others do. Treatment can include medicines, catheter procedures, surgery, and heart transplants. The treatment depends on the type of the defect, how severe it is, and a child's age, size, and general health.
A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart.
Congenital heart disease occurs as a result of an early developmental problem in the heart’s structure. The defect typically interferes with the normal flow of blood through the heart, which may affect breathing.
Congenital heart disease is one or more problems with the heart's structure that exist since birth. Congenital means that you're born with the defect. Congenital heart disease, also called congenital heart defect, can change the way blood flows through your heart. IF YOU LIKE GIVE YOUR LIKES AND FOLLOW THIS LINK
The lecture is for medical student. It is from Dr RUSINGIZA Emmanuel, MD, senior lecture at UR( UNIVERSITY OF RWANDA) .
It will help to understand heart diseases in newborn, infants and children.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
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Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
1. Pre by lect: ZAHID REHMAN
IPMS(KMU)
Congenital heart disease
2. Congenital heart defects are heart problems that
develop before birth. They can occur in the
heart's chambers, valves or blood vessels. A baby
may be born with only one defect or with several
defects. Other types of congenital heart defects
are life-threatening, either immediately to the
newborn or over time.
3. congenital cardiac malformations resulting
from defective embryonic development
without obvious cause.
Between 3-8 weeks “gestation” all the fetal
heart structures are formed “organogenesis”
`
7. Common Cyanotic Lesions
Tetralogy of fallot (TOF)
Transposition of great vessels
Truncus arteriiousus
Total anomalous pulmonary venous return
Hypoplastic left heart syndrome
8. Diagnosis
Early diagnosis of C.H.D mean better results.
40% of C.H.D diagnosed at 1st w of life.
50-60 % diagnosed at 1st two months .
Others are usually later during routine medical
examination.
Diagnosis depend on good clinical history +
good medical examination and investigations.
9. -History of dysnea on exertion.
-Shortness of breathing.
-Orthopnea.
-Lower limbs swelling
-Palpitation.
-Convulsion.
-All may be manifest of congestive heart failure.
Older child
10. Ventricular Septal defects(VSD)
Sometimes called a hole in the heart, this defect
— the most common congenital heart defect —
occurs when the muscular wall (septum)
separating the bottom chambers of the heart
(right and left ventricles) doesn't fully form. The
hole allows oxygen-rich blood to leak from the left
ventricle into the right ventricle, instead of moving
into the aorta and on to the body. In the right
ventricle, the oxygen-rich blood mixes with blood
that doesn't have enough oxygen in it.
11. Single most common congenital heart
malformation, accounting for almost 30% of all
CHD
Defects can occur in both the membranous
portion of the septum (most common) and the
muscular portion
Between 80% and 85% of all VSDs
< 3 mm in diameter
All close spontanously
50% by 2 years
90% by 6 years
10% during school years
Muscular close sooner than membranous
12. Ventricular septal defect can lead to
Heart failure
High blood pressure in the lungs (pulmonary
hypertension),
Infection of the heart (endocarditis)
Irregular heartbeats (arrhythmias)
Delayed growth.
Small holes may heal on their own or cause no
symptoms. Larger holes may require surgery to
stitch the hole closed or to cover the hole with a
patch.
15. Atrial septal defect
Atrial septal defect is a hole that occurs when the
muscular wall (septum) separating the top two
chambers of the heart (right and left atria) doesn't
close properly. This allows oxygen-rich blood from
the left atrium to flow into the right atrium, where
it mixes with blood that doesn't have adequate
oxygen in it. Blood from the left atrium should
normally flow into the left ventricle and on to the
aorta and the rest of the body.
Minor cases may cause no symptoms and may
not require treatment. Larger defects may require
surgery or cardiac catheterization to repair the
hole.
16.
17. A large ASD may be associated with growth failure
in infants and children. It.s more common in
women then in men.
Types :
There are three types of ASD
1. Ostium secundum ASD (75%)
Most common type and result from defect in the
region of the fossa ovalis . In this type there is
no involment of AV valve.
18. 2. Ostium primum ASD (15%)
Ostium primum ASD result from absence of septum
primum (at the lower portion of the artrial septum.
In this type there is also involvement of AV valves.
3. Sinus venosus defect(10%)
Sinus venosus defect is in the upper part of the
septum near the entrance of the inferior venacava
and coronary sinus there for producing
communication between coronary sinus and left
atrium.
19. Clinical feature
Asymptomatic
Exertional dyspnea after 30 age
Pts are more prone to developed pulmonary
infection
Right ventricular failure with large defect and
prolonged pulmonary hypertension may develop
later in life.
20. Enlargement of the right ventricle
Enlargement of atrium
Large pulmonary artery
increased pulmonary vascularity is.
21. Patent ductus arteriosus(PDA)
Before birth, a blood vessel called the ductus
arteriosus connects the pulmonary artery — the
artery carrying blood to the lungs — and the
aorta, the large artery that carries blood away
from the heart. Before a baby is born, the ductus
arteriosus allows blood to bypass the lungs
because the baby receives oxygen through the
placenta and umbilical cord. The ductus
arteriosus normally closes within soon after birth.
If the ductus arteriosus remains open (patent),
some blood that should flow through the body
goes to the lungs.
22. This defect can cause heart failure or an infection
of the heart (endocarditis). In infants, it can be
closed with medications. In older children and
adults, surgery is performed to close the vessel.
Accounts for about 10% of all cases of CHD
Higher incidence of PDA in infants born at high
altitudes (over 10,000 feet)
More common in females
26. Pulmonary valve stenosis
In this condition, blood flow from one of the
heart's bottom chambers, the right ventricle, to
the pulmonary artery is slowed by narrowing at
the pulmonary valve. When there's narrowing
(stenosis), the right ventricle must pump harder to
get blood into the artery that carries blood to the
lungs (pulmonary artery). Pulmonary valve
stenosis may occur along with other defects, such
as thickening of the muscle of the right ventricle
below the valve.
27. In many cases, pulmonary valve stenosis is mild
and doesn't require treatment.
But because it can cause
heart failure
arrhythmias
enlargement of the right heart chambers
It may be necessary to correct the defect. In many
cases, a balloon (pulmonary valvuloplasty) opens
the narrowed valve. In some cases, especially in
people with other heart defects, surgery may be
necessary to replace the diseased valve with an
artificial valve.
28.
29. Aortic stenosis
Aortic stenosis is a defect that narrows or blocks
the aortic valve opening, making it difficult for the
heart to pump blood into the aorta — the main
artery leading away from the heart — on to the
rest of the body.
The defect can cause the heart to get bigger
left-sided heart failure
abnormal heart rhythms (arrhythmias),
infections of the heart (endocarditis)
fainting.
30. Treatment:
Treatment includes surgery to repair or replace the
valve .
In young children, widening of the valve through a
surgical procedure called balloon valvuloplasty, in
which a balloon-like device widens the valve so
that blood can flow through.
31.
32. Coarctation of the aorta
This is a narrowing (coarctation) in a portion of
the heart's main artery (aorta). Coarctation forces
the heart to pump harder to get blood through the
aorta and on to the rest of the body.
Coarctation of the aorta can cause several life-
threatening complications including
severe high blood pressure
a bulge in the aorta that can burst (aortic
aneurysm)
infection of the heart (endocarditis)
brain hemorrhage
33. stroke
heart failure
Treatment:
Repair is typically recommended before age 10,
either by surgically removing the affected portion
or widening it through a surgical procedure called
balloon angioplasty and placement of a mesh
tube that can hold the aorta open (stent).
34.
35. Transposition of the great arteries
With this defect, the positions of the aorta — the
main artery leading away from the heart — and
the pulmonary artery, which leads to the lungs,
are reversed (transposed). The aorta and
pulmonary artery are, together, sometimes
referred to as the great arteries. In transposition
of the great arteries, the aorta arises from the
right ventricle instead of the left ventricle and the
pulmonary artery arises from the left ventricle
instead of the right. This prevents nourishing
oxygenated blood from reaching the body.
36. This condition would quickly be fatal to a newborn
except it's generally accompanied by another
defect — commonly a septal defect or patent
ductus arteriosus — that allows oxygen-rich blood
to get to the body. Surgery to repair the condition
is usually necessary shortly after birth.
37.
38. Tetralogy of Fallot
This defect is a combination of four (tetralogy) heart
defects. The four defects typically are ventricular
septal defect (VSD), pulmonary valve stenosis, a
misplaced aorta and a thickened right ventricular
wall (right ventricular hypertrophy). They usually
result in an insufficient amount of oxygenated blood
reaching the body.
Complications of tetralogy of Fallot (fuh-LOE)
include cyanosis — sometimes called "blue baby
syndrome," since the lips, fingers and toes may have
a bluish tinge from lack of oxygen.
39. as well as poor eating, physical inability to
exercise, irregular heartbeats (arrhythmias),
delayed growth and development, and stroke.
Surgery to repair the defects is required early in
life.
40.
41. Ebstein's anomaly
This is a defect of the tricuspid valve, which controls
blood flow between the heart's right atrium, which is
an upper chamber of the heart, and the right
ventricle, a bottom chamber of the heart. The valve
is positioned lower than normal into the right
ventricle instead of remaining between the atrium
and the ventricle. The incorrectly formed ventricle is
too small and the atrium too large, and neither
functions properly. The valve often allows blood to
leak from the ventricle into the atrium. This defect
often occurs along with other heart defects.
42. Some people have symptoms early in life,
including heart failure and life-threatening
irregular heartbeats (arrhythmias). Other people
may have no signs or symptoms until adulthood.
Treatment is with medications or with surgery.
43.
44. Atrioventricular canal defect
This is a combination of defects, including a large hole in the
center of the heart and a single common valve instead of the
separate tricuspid and mitral valves. Also called atrioventricular
septal defect, this defect is classified by whether it's only partial
(involving only the upper chambers of the heart), or complete (in
which blood can travel freely among all four chambers of the
heart). Both forms of the defect allow extra blood to circulate to
the lungs, causing the heart to enlarge.
The condition occurs most often in children with Down syndrome.
Infants may also have trouble breathing and not grow well.
Surgery is often done in infancy to close the hole and reconstruct
the valves.
45.
46. Truncus arteriosus
This is a defect in which the normally separate pulmonary
artery and aorta merge into one single large vessel (truncus)
arising from the two bottom chambers of the heart (right and
left ventricles). Many people who have this defect also have
a large ventricular septal defect, which turns the right and left
ventricles into a single chamber. This allows red oxygenated
blood and blue unoxygenated blood to mix. Too much blood
may flow to the lungs, flooding them and making it difficult to
breathe. It can also result in life-threatening pulmonary
hypertension — high blood pressure in the lungs.
Surgery is needed to close the septal defect with a patch and
to separate the pulmonary arteries from the trunk.