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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tricuspid Atresia Michael P. D'Alessandro, M.D. Peer Review Status: Internally Peer Reviewed   www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
c)  Over time PVR    to that of SVR i) reverses shunt (cyanosis) 2.-   R to L shunt a)     pulmonary blood flow i)  Cyanosis “blueness” of skin b)  examples: i)  tetralogy of Fallot  ii)  great vessel transposition iii)  truncus arteriosus iv)  tricuspid atresia v)  anomalous pulmonary venous   connection www.freelivedoctor.com
c)  long standing cyanosis is        associated with “clubbing” of the    tips of the fingers and toes www.freelivedoctor.com
3.-   Obstructions (of flow) a)  coarctation of the aorta b)  valvular stenosis i)  aortic ii)  pulmonary  c)  complete obstruction is called      “Atresia” www.freelivedoctor.com
[object Object],[object Object],[object Object],www.freelivedoctor.com
i)  VSD most common -  close spontaneously (50%)  ii)  ASD usually not symptomatic      before 30 yrs www.freelivedoctor.com
iii)  DA remains open after birth -  ~ 90% occur as isolated    anomaly  -  reversal of flow with    PVR   causes cyanosis -  PGE will maintain DA cardiac defects such as    obstructive disease  iv)  complete atrioventricular canal    defect -  all 4 chambers freely    communicate (Down syndrome) www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
    www.freelivedoctor.com
Tetralogy of Fallot (TOF) Michael P. D'Alessandro, M.D. Peer Review Status: Internally Peer Reviewed   ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
-  PDA, foramen ovale     unstable shunt (close quickly    after birth)    need surgery ,[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
[object Object],[object Object],[object Object],www.freelivedoctor.com
ii)  It is classified  by the absence of tricuspid valve, pulmonary stenosis, and VSD.  iii) The most  Common form  is also associated With a hypoplastic  right ventricle www.freelivedoctor.com
TRICUSPID ATRESIA 1 - atrial septal defect 2 - absent tricuspid valve 3 - ventricular septal defect Blood is shunted through an atrial septal defect to the left atrium and through the ventricular septal defect to the pulmonary artery. The shaded arrows indicate mixing of the blood.  www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
1  - superior vena cava 2  - atrial septal defect 3  - left innominate vein 4  - pulmonary veins Oxygenated blood returning from the lungs is routed back into the superior vena cava, rather than the left atrium. The presence of an atrial septal defect is necessary to allow partially oxygenated blood to reach the left side of the heart.  Total Anomalous Pulmonary Venous Connection (TAPVC) www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
1  - pinched or coarcted aorta flow patterns are normal but are reduced below the coarctation. Blood pressure is increased in vessels leaving the aorta above the coarctation. The broken white arrow indicates diminished blood flow through the aorta.  www.freelivedoctor.com
www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Aortic stenosis (valvular) 1 - narrowed aortic valve Flow patterns are normal but blood flow to the aorta is reduced as indicated by the broken white arrows  www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Subaortic Stenosis   www.freelivedoctor.com
www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
ii)     wall thickness iii)     cavity diameter c)  volume overload i)  “eccentric hypertrophy” ii)  chamber dilation iii)     ventricular diameter iv)  wall thickness may not change -  owing to simultaneous    hypertrophy d)     capillary density with        hypertrophy i)     demands    ischemia !!  www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
ii)  when Left heart failure is    present, hypoxic liver shows    signs of “centrilobular    necrosis” iii)  long standing Right failure -  cardiac cirrhosis  iv)  portal hypertension -  congestive splenomegaly v)  ascites  vi)  pleural and pericardial    effusions  accompany Right    heart failure www.freelivedoctor.com
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
b)   infections c)  malignancies i)  lymphomas -  Ebstein-Barr virus www.freelivedoctor.com

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Congenital heart disease heart failure

  • 1.
  • 2.
  • 3. c) Over time PVR  to that of SVR i) reverses shunt (cyanosis) 2.- R to L shunt a)  pulmonary blood flow i) Cyanosis “blueness” of skin b) examples: i) tetralogy of Fallot ii) great vessel transposition iii) truncus arteriosus iv) tricuspid atresia v) anomalous pulmonary venous connection www.freelivedoctor.com
  • 4. c) long standing cyanosis is associated with “clubbing” of the tips of the fingers and toes www.freelivedoctor.com
  • 5. 3.- Obstructions (of flow) a) coarctation of the aorta b) valvular stenosis i) aortic ii) pulmonary c) complete obstruction is called “Atresia” www.freelivedoctor.com
  • 6.
  • 7. i) VSD most common - close spontaneously (50%) ii) ASD usually not symptomatic before 30 yrs www.freelivedoctor.com
  • 8. iii) DA remains open after birth - ~ 90% occur as isolated anomaly - reversal of flow with  PVR causes cyanosis - PGE will maintain DA cardiac defects such as obstructive disease iv) complete atrioventricular canal defect - all 4 chambers freely communicate (Down syndrome) www.freelivedoctor.com
  • 9.
  • 11.
  • 12.
  • 13.
  • 16.
  • 18.
  • 19. ii) It is classified by the absence of tricuspid valve, pulmonary stenosis, and VSD. iii) The most Common form is also associated With a hypoplastic right ventricle www.freelivedoctor.com
  • 20. TRICUSPID ATRESIA 1 - atrial septal defect 2 - absent tricuspid valve 3 - ventricular septal defect Blood is shunted through an atrial septal defect to the left atrium and through the ventricular septal defect to the pulmonary artery. The shaded arrows indicate mixing of the blood. www.freelivedoctor.com
  • 21.
  • 22. 1 - superior vena cava 2 - atrial septal defect 3 - left innominate vein 4 - pulmonary veins Oxygenated blood returning from the lungs is routed back into the superior vena cava, rather than the left atrium. The presence of an atrial septal defect is necessary to allow partially oxygenated blood to reach the left side of the heart. Total Anomalous Pulmonary Venous Connection (TAPVC) www.freelivedoctor.com
  • 23.
  • 24.
  • 25. 1 - pinched or coarcted aorta flow patterns are normal but are reduced below the coarctation. Blood pressure is increased in vessels leaving the aorta above the coarctation. The broken white arrow indicates diminished blood flow through the aorta. www.freelivedoctor.com
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  • 30. Aortic stenosis (valvular) 1 - narrowed aortic valve Flow patterns are normal but blood flow to the aorta is reduced as indicated by the broken white arrows www.freelivedoctor.com
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  • 32. Subaortic Stenosis www.freelivedoctor.com
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  • 35.
  • 36.
  • 37.
  • 38. ii)  wall thickness iii)  cavity diameter c) volume overload i) “eccentric hypertrophy” ii) chamber dilation iii)  ventricular diameter iv) wall thickness may not change - owing to simultaneous hypertrophy d)  capillary density with hypertrophy i)  demands  ischemia !! www.freelivedoctor.com
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  • 40.
  • 41.
  • 42.
  • 43. ii) when Left heart failure is present, hypoxic liver shows signs of “centrilobular necrosis” iii) long standing Right failure - cardiac cirrhosis iv) portal hypertension - congestive splenomegaly v) ascites vi) pleural and pericardial effusions accompany Right heart failure www.freelivedoctor.com
  • 44.
  • 45. b) infections c) malignancies i) lymphomas - Ebstein-Barr virus www.freelivedoctor.com