Congenital heart disease
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1. The document discusses two congenital heart defects, Tetralogy of Fallot and Transposition of the Great Vessels. Tetralogy of Fallot is characterized by four features and leads to cyanosis if left untreated. 2. Transposition of the Great Vessels involves the transposition of the aorta and pulmonary artery, which prevents oxygenated blood from reaching the body. It requires measures to maintain ductal flow or creation of communications between ventricles. 3. The document outlines evaluations, investigations, surgical procedures, and goals/risks of management for both conditions.
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Congenital heart defects
Congenital heart defects are problems with the heart's structure that are present at birth. They can involve the interior walls, valves, or arteries and veins around the heart. Signs and symptoms depend on the type and severity of defect and may include shortness of breath, cyanosis, fainting, or murmurs. Congenital heart defects are caused by genetic and environmental factors and occur during embryonic development when heart structures are forming.
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Congenital heart disease (CHD) occurs in 1 in 125 live births and is the most common birth defect. The majority of cases have no known cause and are thought to be due to a combination of genetic and environmental factors. Common types of CHD include atrial septal defects, ventricular septal defects, patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Treatment options include medical management, interventional procedures such as catheterization, and surgical repair. Without treatment, CHD can lead to heart failure, lung problems, and other issues.
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3) Right to left shunts like tetralogy of Fallot and transposition of the great vessels that present with cyanosis when the duct closes.
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- Babies born with this condition require holes between the atria and ventricles, or a patent ductus arteriosus, to allow blood to reach the lungs. Multiple surgeries are usually needed like shunt procedures or Fontan operations.
- Symptoms appear soon after birth and include blue skin color, breathing difficulties, and heart murmurs. Diagnosis involves various tests like echocardiograms.
- Long term, children may develop issues like heart rhythm problems, valve leaks, or endocarditis which are monitored lifelong
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The document discusses acyanotic heart disease, which refers to congenital heart defects present at birth that do not cause cyanosis. Common types include atrial septal defect, ventricular septal defect, and patent ductus arteriosus. These defects cause diminished pulmonary blood flow due to left-to-right shunting. Symptoms may not be present initially but can develop over months or years and include dyspnea, fatigue, and heart failure. Diagnosis involves physical exam, chest x-ray, ECG, and echocardiogram. Treatment depends on the severity but may involve surgery to correct the structural abnormality, with earlier intervention reducing long-term risks from conditions like pulmonary hypertension.
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The document provides information on congenital heart defects, including their causes, types, signs and symptoms, diagnosis, and treatment. It discusses several specific defects in detail, including aortic stenosis, coarctation of the aorta, pulmonary stenosis, and patent ductus arteriosus. The key points are:
1. Congenital heart defects can involve the heart's chambers, valves, or vessels and have various causes including genetic syndromes.
2. Specific defects like aortic stenosis and pulmonary stenosis can cause obstruction to blood flow while others like patent ductus arteriosus allow extra blood flow to the lungs.
3. Symptoms depend on the severity of the defect but may include heart failure,
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H l h s
Hypoplastic Left Heart Syndrome (HLHS) occurs when parts of the left side of the heart do not develop completely, making the left ventricle nonfunctional and unable to supply blood to the systemic circulation. It is present at birth and requires ductal patency for systemic blood flow. The condition causes the right side of the heart to maintain circulation for both the lungs and body. Without intervention after ductal closure, shock and death will rapidly occur due to poor organ perfusion. The standard treatment is a staged surgical approach involving three procedures over several years to reconstruct the heart and establish adequate circulation.
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This document discusses several types of cyanotic congenital heart disease:
1. Tetralogy of Fallot is the most common cyanotic heart disease, characterized by four anatomical features - ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. It causes cyanosis due to right-to-left shunting.
2. Transposition of the great arteries involves the aorta arising from the right ventricle and pulmonary artery from the left ventricle. It requires mixing of blood between circulations to survive.
3. Truncus arteriosus is a rare condition where a single artery supplies both circulations. It is usually associated with a ventricular septal defect.Congenital heart disease
This document discusses congenital heart disease (CHD), including atrial septal defects (ASD) and tetralogy of Fallot (TOF). It defines the conditions, describes their signs and symptoms, and outlines their treatment and nursing care. Key points include the definition of ASD as an abnormal opening between the atria, and TOF as having four structural defects including pulmonary stenosis and a ventricular septal defect. Nursing focuses on decreasing cardiac workload, preventing infection, and supporting nutrition and development.
Congenital heart disease (chd)
This document provides information on congenital heart disease (CHD). It discusses the epidemiology and etiology of CHD. It then describes the relative frequency of different congenital heart lesions. It provides clues for evaluating infants with suspected CHD and discusses various cyanotic and acyanotic CHD conditions like ventricular septal defects, tetralogy of Fallot, transposition of the great arteries and Ebstein's anomaly in detail including their pathophysiology, clinical manifestations, diagnosis and treatment.
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A good ppt on Clinical congenital heart disease for Post Graduate
A good ppt on Clinical congenital heart disease for Post Graduate
Noncompaction Cardiomyopathy, NGUYEN TUAN VU, NGUYEN THI KIM SANG, DUONG PHI ...
Noncompaction Cardiomyopathy, NGUYEN TUAN VU, NGUYEN THI KIM SANG, DUONG PHI ...
Segmental approach in congenital heart disease [autosaved].pptx 2.pptx final
Segmental approach in congenital heart disease [autosaved].pptx 2.pptx final
AIUM Practice Guideline for the Performance of Fetal Echocardiography
AIUM Practice Guideline for the Performance of Fetal Echocardiography
Classification of Congential Heart Diseases and cyanotic heart disease
Classification of Congential Heart Diseases and cyanotic heart disease
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Transposition of great arteries
Transposition of the great arteries (TGA) is a congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, causing parallel instead of serial circulation. TGA accounts for 5-7% of congenital heart diseases and has an annual incidence of 20-30 per 100,000 live births. Without treatment, TGA is incompatible with long-term survival due to lack of oxygen supply. Initial treatment involves prostaglandin E1 to maintain ductal patency and increase pulmonary blood flow. Later procedures include the Rastelli operation or arterial switch operation to correct the defect.
CONGENITAL HEART DISEASE & ANAESTHESIA by Dr.Sravani Vishnubhatla
1) Congenital heart defects are the most common birth defects, affecting 1 in 125 live births. They range from simple shunt lesions to complex defects involving multiple structures.
2) The anesthetic goals vary depending on the type of shunt (left-to-right vs right-to-left) and aim to balance systemic and pulmonary vascular resistances.
3) Preoperative evaluation and optimization is important. Regional techniques may be used when hemodynamically appropriate but general anesthesia allows better control of ventilation and hemodynamics for high risk surgery.
Anesthesia For Children With Congenital Heart Disease1
This document discusses children with congenital heart disease and provides information on:
1. The incidence of congenital heart disease is 7 to 10 per 1000 live births, with certain populations having higher rates.
2. Congenital heart disease can range from simple defects like atrial septal defects to complex conditions like hypoplastic left heart syndrome.
3. Proper preoperative evaluation is important for anesthetic planning and involves understanding the child's specific cardiac anatomy and physiology.
A case of ASD - Sinus Venosus type
- The patient is a 36-year-old male who presented with palpitations and breathlessness on exertion. Echocardiogram revealed an atrial septal defect (ASD) of the sinus venosus type with anomalous pulmonary venous drainage and moderate pulmonary hypertension.
- Sinus venosus ASDs account for 10% of ASDs and involve a defect between the superior vena cava and right atrium, often associated with anomalous pulmonary vein drainage.
- Surgical repair is the treatment of choice, involving use of a patch to redirect pulmonary vein flow to the left atrium while closing the interatrial communication.
Congenital Heart Diseases in Newborns - Rivin
Acyanotic Congenital Heart Diseases;
1. Left-to-right shunts
a. Ventricular Septal Defect(VSD)
b. Atrial Septal Defect(ASD)
c. Patent Ductus Arteriosus(PDA)
d. Atrioventricular Septal Defect(AVSD)
e. Aortopulmonary window
* Eisenmenger Syndrome – The shunt becomes right-to-left
2. Left-sided obstructive lesions
a. Coarctation of the Aorta(COA)
b. Congenital Aortic Stenosis
c. Mitral Stenosis
d. Interrupted Aortic Arch
Cyanotic Congenital Heart Diseases;
1. Right-to-left shunts
a. Tetralogy of Fallot
b. Pulmonary stenosis
c. Pulmonary atresia
d. Tricuspid atresia
e. Ebstein’s anomaly
2. Complete mixed lesions
a. Transposition of the great vessels
b. Double outlet right ventricle(DORV)
c. Total anomalous pulmonary venous return
d. Truncus arteriosus
e. Hypoplastic left heart syndrome
Congenital Heart Defects
The document discusses various congenital heart defects including their definition, etiology, classification as acyanotic or cyanotic, signs and symptoms, diagnosis, and treatment. Specific defects covered include atrial septal defects, ventricular septal defects, patent ductus arteriosus, and atrioventricular septal defects. The treatment sections provide guidelines for managing each defect medically or surgically depending on its size and severity.
Endocardial Cushion Defect / AVSD
Brief information about clinical manifestation and management of Endocardial Cushion Defect / atrioventricular defect
Congenital heart disease,anesthetic management
Congenital heart disease,anesthetic managementSindh Institute of Urology and Transplantation.SIUT,PAKISTAN
There are over 100 different types of congenital heart disease that can be categorized into 9 major groups. The most common are ventricular septal defects (VSD), atrial septal defects (ASD), patent ductus arteriosus (PDA), and tetralogy of Fallot. For any congenital heart disease, the anesthesiologist must understand the pathophysiology of the defect and how changes in systemic and pulmonary vascular resistance may impact blood flow and oxygen saturation. The goal is to avoid maneuvers that could increase intracardiac shunting and hypoxemia based on whether it is a left-to-right or right-to-left shunt. Thorough preoperative evaluation including echocardiUremic Pericarditis
The document discusses uremic and dialysis-associated pericarditis. Key points include:
- Pericarditis is inflammation of the pericardium and can be caused by uremia or inadequate dialysis. It commonly causes chest pain and may develop effusions or tamponade.
- Diagnosis involves echocardiogram, EKG changes and ruling out other causes. Treatment is intensive dialysis, medications like NSAIDs or colchicine, and pericardiocentesis for large effusions or tamponade.
- Prognosis is generally good with early management but pericarditis was once common in renal failure and can still cause morbidity or mortality if
ANESTHESIA FOR CHD.pptx
This document provides an overview of congenital heart disease (CHD) and anesthesia considerations for CHD. It begins with definitions and classifications of CHD, including acyanotic and cyanotic defects. Specific conditions discussed include atrial septal defect, ventricular septal defect, patent ductus arteriosus, pulmonary stenosis, aortic stenosis, and coarctation of the aorta. For each condition, the document outlines etiology, pathophysiology, clinical presentation, diagnosis, and treatment considerations.
Asd and vsd
This document discusses congenital heart disease in adults. It notes that 1 million adults in the US have congenital heart disease, with 20,000 more reaching adulthood each year due to increased survival of children with CHD. Common adult presentations of CHD include effort dyspnea, atrial fibrillation, and right heart failure. The document reviews the pathophysiology, clinical features, diagnostic evaluation, and management of various CHD lesions that may present in adulthood, such as atrial septal defects, ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, Ebstein's anomaly, and coarctation of the aorta. Surgical and percutaneous interventions are discussed
CONGENITAL HEART DISEASES
This document provides information about acyanotic heart defects, including definitions, causes, pathophysiology, clinical manifestations, diagnosis, management, and complications. It discusses several types of acyanotic heart defects such as atrial septal defect (ASD), ventricular septal defect (VSD), atrioventricular canal defect, patent ductus arteriosus (PDA), coarctation of the aorta, and aortic stenosis. For each condition, it outlines the definition, incidence, types if applicable, pathophysiology that occurs due to the structural abnormality, associated signs and symptoms, diagnostic evaluation, treatment options including medical management and surgery, and potential complications.
Acyanotic hd
This document presents information from a presentation on acyanotic congenital heart disease. It begins with objectives that cover fetal circulation, defining CHD and risk factors, classifying CHD, explaining acyanotic heart disease and specific defects. It then provides detailed information on ventricular septal defect, atrial septal defect, patent ductus arteriosus, aortic stenosis, pulmonary stenosis, and coarctation of aorta. For each defect, it discusses clinical manifestation, diagnostic criteria, management, and complications. It also includes summaries of two research papers on neurodevelopmental outcomes after surgery for acyanotic CHD and a comparison of renal function between cyanotic and acyanotic CHD in children.
Common heart conditions in children copy.pptx
This document discusses common congenital and acquired heart conditions in children. It begins by describing fetal circulation and how congenital heart diseases arise from defects present at birth. The conditions are classified as acyanotic or cyanotic depending on whether they allow mixing of oxygenated and deoxygenated blood. Common acyanotic conditions discussed include atrial septal defect, ventricular septal defect, and patent ductus arteriosus. Cyanotic conditions include tetralogy of Fallot and transposition of the great vessels. The document also covers acquired conditions like rheumatic fever and infective endocarditis, as well as their presentation, diagnosis, and management.
Anaesthesia for closed heart procedures pda & coa
This document discusses anaesthetic considerations for closed heart procedures including those correcting lesions like patent ductus arteriosus and coarctation of the aorta, as well as palliative procedures like banding of the pulmonary artery. It covers the relevant anatomy, pathophysiology, clinical presentation, diagnosis and management of these conditions. Specifically, it emphasizes the importance of invasive hemodynamic monitoring during surgery due to risks of hypotension and paraplegia from spinal cord ischemia. Careful blood pressure control is needed during and after the procedures.
cardiac emergencice im pediatrics
A 2-day-old infant presented with shock and was found to have severe coarctation of the aorta. After discharge from the hospital following delivery, the infant collapsed at home. Examination showed poor perfusion and enlarged liver. Echocardiogram revealed severe coarctation, and the infant went into shock once the ductus arteriosus closed, obstructing left heart outflow. Management involved prostaglandin infusion to keep the ductus patent and stabilize the infant until surgery.
Complete transposition of the great arteries (D-TGA.pptx
Complete transposition of the great arteries (D-TGA) is a congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This results in deoxygenated blood circulating to the body and oxygenated blood recirculating to the lungs. Without intervention, D-TGA is fatal in infancy due to hypoxia and heart failure. Treatment involves atrial septostomy to improve mixing, followed by surgical repair such as the arterial switch operation or atrial baffle procedures to redirect blood flow. The arterial switch operation has better long-term outcomes.
Atrial septal defect
The document discusses atrial septal defect (ASD), including its embryology, types, pathophysiology, natural history, evaluation, and management. ASD is a congenital heart defect characterized by an opening in the interatrial septum that causes blood to flow from the left atrium to the right atrium. The size and location of the defect determines symptoms and treatment, which may include medical management, interventional closure, or surgical repair.
Acute pulmonary embolism
This document discusses acute pulmonary embolism (PE), including its presentation, risk factors, diagnostic workup, and management. PE is a potentially life-threatening condition that is often missed or difficult to diagnose due to vague symptoms. Timely treatment is important as untreated PE has a 20-30% mortality rate. Diagnostic tests include D-dimer, CT pulmonary angiogram, ventilation-perfusion scan, and angiogram. Initial treatment involves anticoagulation with heparin or fondaparinux. Long-term anticoagulation with warfarin is recommended to prevent recurrence. Thrombolysis or embolectomy may be considered for massive PE with hemodynamic instability.
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There are several types of Mapleson breathing systems classified based on the position of the reservoir bag. Mapleson A has an afferent reservoir with the bag attached to the fresh gas inlet. Mapleson D has an efferent reservoir with the bag attached to the patient outlet. Both systems allow for spontaneous or controlled ventilation but Mapleson D is more efficient due to continuous mixing of fresh gas and exhaled gases. The systems are tested for leaks and proper functioning using various occlusion and pressurization techniques.
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2) The lumbar and sacral plexuses give rise to various nerves that can be blocked individually or as combinations to anesthetize the lower limb, including the femoral, lateral femoral cutaneous, and obturator nerves.
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Koshy
This patient has a history of myocardial infarction, triple vessel coronary artery disease, and is scheduled for elective non-cardiac surgery. Based on his positive stress test results and coronary angiogram showing severe blockages, the cardiologist recommends coronary artery bypass graft surgery prior to the planned surgery to improve his long-term prognosis and reduce perioperative cardiac risks.
Iv induction agents
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2. Ketamine is a non-competitive NMDA receptor antagonist, thiopentone enhances GABA activity, and propofol directly activates GABA receptors.
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The document summarizes a study on the effect of preemptive gabapentin on postoperative pain and opioid requirement following head and neck surgeries. The study involved 60 patients divided into a gabapentin group and a control group. Pain scores and opioid requirements were significantly lower in the gabapentin group compared to the control group over 24 hours post-surgery. Heart rate, blood pressure and nausea were also lower in the gabapentin group. The study concludes that preemptive gabapentin effectively reduces postoperative pain and opioid needs following head and neck surgeries.
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2. Topical anesthesia techniques for awake fiberoptic intubation, including nerve blocks to anesthetize the nasal passages, pharynx, and larynx
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An 80-year-old woman presented with right upper abdominal pain and nausea/vomiting. She had a history of hypertension, hypothyroidism, obstructive sleep apnea, and recurrent urinary tract infections. Examination and investigations revealed acute obstructive cholecystitis. She underwent an open cholecystectomy with combined spinal-epidural anesthesia and was managed post-operatively with epidural analgesia and intravenous fluids. She recovered well and was discharged on the third post-operative day.
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Upper limb nerve blocks provide anesthesia for surgeries on the arm and hand. The brachial plexus supplies sensation and movement to the upper limb and can be blocked at different levels, including supraclavicular, interscalene, axillary, and infraclavicular. Nerve stimulators can help locate nerves more accurately than paresthesia alone. Potential complications depend on the specific block but may include pneumothorax, phrenic nerve block, and accidental spinal or epidural injection.
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