Congenital heart disease is the most common type of birth defect, affecting around 1 in 1000 live births. It involves defects in the structure or function of the heart present at birth. Common types include ventricular septal defect, atrial septal defect, patent ductus arteriosus, tetralogy of Fallot, and transposition of the great arteries. Causes may be genetic factors, environmental exposures during pregnancy, or both. Imaging plays an important role in diagnosis and surgical planning, with modalities like echocardiography, CT, MRI, and angiography used to characterize the anatomy and assess blood flow patterns through the heart. Treatment depends on the specific defects but may involve cardiac catheterization, balloon angioplast
Definition:
Also known as Hypoplastic Right Heart Syndrome (HRHS)
It is a rare congenital cardiac lesion characterized by heterogeneous right ventricular development, an imperforate pulmonary valve, and possible extensive ventriculocoronary connections.
It is a type of congenital cyanotic heart disease, a severe form of Tetralogy of Fallot (TOF)
Newborn patients present cyanotic with high desaturation and pulmonary blood flow that depend on patent ductus arteriosus
Carotid artery disease is commonly seen in association with atherosclerosis and complicate the situation. clearcut guidelines with necessary surgical details are provided in presentations.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Definition:
Also known as Hypoplastic Right Heart Syndrome (HRHS)
It is a rare congenital cardiac lesion characterized by heterogeneous right ventricular development, an imperforate pulmonary valve, and possible extensive ventriculocoronary connections.
It is a type of congenital cyanotic heart disease, a severe form of Tetralogy of Fallot (TOF)
Newborn patients present cyanotic with high desaturation and pulmonary blood flow that depend on patent ductus arteriosus
Carotid artery disease is commonly seen in association with atherosclerosis and complicate the situation. clearcut guidelines with necessary surgical details are provided in presentations.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. CONGENITAL HEART DISEASE
BORN WITHA BROKENHEART
Dr. Sabnam Parvin, Dr. Dijendra
Radiodiagnosis
IPGME&R and SSKM Hospital
2. INTRODUCTION
• Most common type of birth defect
• Defect in structure or function of the heart and great vessels
• 1 in 1000 live births
• The incidence is higher in stillborns (3-4%), spontaneous
abortuses (10-25%), and premature infants
• About 1 in 4 babies born with a heart defect has a critical heart
disease
34. Environmental factors
• Viral Infections: rubella during the first three months of pregnancy
• Medication: lithium ,Accutane , some anti-seizure medications
• Alcohol: Fetal alcohol syndrome (FAS)
• Smoking
• Cocaine
• Maternal chronic illnesses –Diabetes, phenylketonuria (PKU) and a
deficiency in the B vitamin folic acid.
35. Genetic factors
• Heredity –occur in siblings or offspring of individuals with heart
defects than those without.
• Mutations –can affect the formation of the heart and lead to
congenital heart malformations
• Linked with other birth defects – More than one-third of children
born with Down syndrome have heart defects. About 25% of girls
with Turner syndrome have heart defects
39. Atrial septal defect
• 2nd most common CHD after VSD
• the lesion is typically asymptomatic until adulthood
• Gradual (high output) CCF eventually develops, usually
becoming symptomatic by the age of 30.
• ~10% of congenital heart disease
• Female > Male
40. Types:
• Secondum ASD (MC)
• Primum ASD (ȃ Down syndrome)
• Sinus venosus ASD
• Coronary sinus type of ASD
41. Plain Radiograph
• Can be normal
• Sings of increased pulmonary flow
• enlarged pulmonary vessels
• upper zone vascular prominence
• vessels visible to the periphery of the film
• eventual signs of PAH
• chamber enlargement
• RA & RV
• LA is normal in size and Aortic arch is normal or small
42. There is cardiomegaly with
enlarged pulmonary conus and
dilated pulmonary arteries more
on the right side with peripheral
pruning of pulmonary vessels.
43. CXR demonstrates an enlarged heart with
prominent vascularity. The aortic arch is
normal or small and the left atrium does not
appear enlarged
46. Ventricular septal defect
• Most common CHD
• Incidence is at ~1 in 400 births
• Never in neonants (present after 4-6wk of birth)
• Clinical feature:
• SOB (suck-rest-suck cycle)
• CCF
• Recurrent pneumonia
• Infective endocarditis
• Pansystolic murmur
47. Types:
• Peri membranous (MC, 50-70%)
• Muscular (90% healed by 2yrs of age)
• Supra crystal (swiss chasse variant)
48. • Can be normal
• Cardiomegaly
• RV ( RV>RA)
• Kerly B line (Pulmonary edema)
• PAH
• Pleural effusion
Plain Radiograph
49. The heart is enlarged and the
lungs are plethoric.
51. Treatment and prognosis
• Prognosis is good
• Usually healed by 2yrs of age
• Medical treatment is for its complications (CCF, Infective endocarditis)
• Surgical treatment:
• Failure of medical treatment
• Supracrystal type
• Age <6months with PAH
52. Atrioventricular septal defect (AVSD)
• atrioventricular canal defects or endocardial cushion
defects,
• involving the atrial septum, ventricular septum, and one or both
of the tricuspid or mitral valve.
• 2-7% of congenital heart defects.
• ~3-4 in 10,000 births
• Clinical features similar as ASD/VSD
• MC associated with Down syndrome
53. • Plane radiograph: cardiomegaly, pulmonary plethora
• Echocardiography: the defect spectrum and often a large defect
of the midline heart.
• Angiography: "Gooseneck" sign on a lateral left ventricular
angiogram.
• MRI: superior in assessing cardiac chamber dimensions and to
assess the presence/extent of ventricular hypoplasia which is a
determinant of surgical risk.
56. Patent ductus arteriosus
• Persistent patency of the ductus arteriosus (normal connection
of the fetal circulation)
• ~1 in 2000 full-term neonates with a F: M of 2:1
• Closed d/t:
• high O2 tension
• Low maternal prostaglandin
• Clinical features:
• CCF
• Recurrent pneumonia
• Infective endocarditis
• PAH
• Loud continuous machine-like murmur
57. • Cardiomegaly
• LA & LV
• Kerly B line (Pulmonary edema)
• PAH
Plain Radiograph
Echocardiography
• TEE and TTE
58. Pulmonary vascularity is increased.
Heart is enlarged with dilated left
ventricle.
The aorta and main pulmonary artery
segment are dilated. Calcifications are
seen at the aortopulmonary window.
59. CT
Krichenko classification based on CT angiography:
• type A: conical ductus, prominent aortic ampulla with narrowing
at pulmonary artery end
• type B: window, short and wide ductus with blending of
pulmonary artery
• type C: long tubular ductus with no constrictions
• type D: multiple constrictions with complex ductus
• type E: elongated ductus with remote constriction
60.
61.
62.
63. Treatment and prognosis
• medical
• Indomethacin: to close the ductus
• endovascular
• various closure devices
• surgical
• clipping or ligation to close
64.
65. Coarctation of the aorta
• narrowing of the aortic lumen
• 5-8% of all congenital heart defects.
• M:F ratio of ~2-3:1.
• Clinical features:
• asymptomatic (non-severe stenosis)
• can present with angina pectoris and leg claudication
• diminished femoral pulses and differential blood pressure between upper and
lower extremities
66. Types
1.infantile (pre-ductal/severe)
• diffuse hypoplasia or narrowing of the aorta from just distal to
the brachiocephalic artery to the level of DA
• the blood supply to the descending aorta is via the PDA
2.adult (juxtaductal, postductal or middle aortic)
• a short segment abrupt stenosis of the post-ductal aorta
• it is due to thickening of the aortic media and typically occurs just distal
to the ligamentum arteriosum
67. Plain radiograph
• Figure of 3 sign
• inferior rib notching: (Roesler sign)
• unusual in patients <5 years of age
• usually the 4th to 8th ribs; occasionally the 3rd to 9th ribs
• b/l rib notching: the coarctation must be distal to the origin of both
subclavian arteries,
• u/l right rib notching: the coarctation lies distal to the brachiocephalic
trunk but proximal to the origin of the left subclavian artery
• associated aberrant right subclavian artery arising after the coarctation
68. slight indentation of the
aorta (figure of 3 sign) with
associated inferior rib
notching (Roesler sign)
75. Treatment and prognosis
• excision of the coarctation and end-to-end anastomosis,
• balloon angioplasty.
• Subclavian flap repair is a common surgical technique used,
where the origin and proximal left subclavian artery is excised,
opened up and sutured onto the aorta.
• If the subclavian is ligated, it is usually anastomosed onto the
left common carotid artery.
76. Interrupted aortic arch
• an uncommon (~1.5%) CHD
• separation between the ascending and descending aorta.
(complete/connected by a fibrous band).
• An accompanying large VSD and/or PDA is frequently present.
• A right-sided descending aorta with aortic interruption is almost
always associated with DiGeorge syndrome
77. Classification(Celoria-Patton)
• type A: 2nd MC, the interruption occurs distal to the left subclavian
arterial origin
• type B: MC (>50%), the break occurs between the left common
carotid and left subclavian arterial origins
• type C: rare, interruption occurs proximal to the left common carotid
arterial origin
Each type is divided into three subtypes 7:
• subtype 1: normal subclavian artery
• subtype 2: aberrant subclavian artery
• subtype 3: isolated subclavian artery that arises from the ductus
arteriosus
78.
79. • Plain radiograph
• often non-specific (the aortic knuckle may be absent or may show
cardiomegaly
• Antenatal ultrasound/Echocardiography
80. Type A1 IAA. VR image (posterior
view) shows the left aortic arch with
aortic interruption just distal to the
left subclavian artery (arrows).
81. Type B3 IAA. VR image (left posterior
oblique view) shows interruption between
the left common carotid artery and the left
subclavian artery (arrowheads). An isolated
right subclavian artery is also seen (arrow).
82. Treatment and prognosis
• very poor prognosis
• Prostaglandin E1 may be given to initial management to keep
the ductus open.
• Surgical correction (either single- or multistage) is the definitive
treatment.
85. Transposition of the great arteries
• 2nd MC cyanotic heart disease.
• MC cyanotic HD in neonates, cyanosis within 24hrs of life.
• ~1 in 5000 births
• An isolated TGA is incompatible with life at birth without one
of the following additional anomalies:
• ASD
• VSD (~35%)
• PDA
• patent foramen ovale
• It is most common in infants of diabetic mothers
101. Total anomalous pulmonary venous return
• abnormal drainage anatomy of the entire pulmonary venous
system
• all systemic and pulmonary venous blood enters the RA and
nothing drains into the LA.
• develop cyanosis and congestive heart failure in the early
neonatal period
102. Classification
Type I: supracardiac (MC)
• pulmonary veins converge to form a left vertical vein which then
drains to either brachiocephalic vein, SVC, or azygous vein
Type II: cardiac (2nd MC)
• drainage is into the coronary sinus and then the right atrium
Type III: infracardiac
• the pulmonary veins join behind the left atrium to form a common
vertical descending vein
• the common descending vein courses anterior to the oesophagus
passes through the diaphragm at the oesophageal hiatus and then
usually join the portal system
• drainage is usually into the ductus venosus, hepatic veins, portal
vein, or IVC
Type IV: mixed pattern (least common)
103.
104. Plain radiograph
• The right heart is prominent
• Classical snow man appearance in supra cardiac type
• also known as figure of 8 heart or cottage loaf heart
• Schmiter syndrome in infra cardiac type
112. Tetralogy of Fallot
• The MC cyanotic HD
• combination of VSD, RVOT Obstruction , overriding aorta, and
late RVH.
• 5 to 10% of all CHD
• 1 in 2000 births
• cyanosis evident in the neonatal period
• Clubbing
• Pulmonary ejection systolic murmur
113. Pathology
1.VSD
2.RVOTO due to
1.infundibular stenosis, or
2.hypoplastic pulmonary valve annulus, or
3.bicuspid pulmonary valve, and/or
4.hypoplasia of pulmonary artery
3.overriding aorta
4.RVH: only develops after birth
119. MRI
• A detailed assessment of the pulmonary artery because the
repair of the cardiac defects without addressing pulmonary
artery hypoplasia or stenosis has a poor outcome
• The main pulmonary artery or right pulmonary artery diameter
should be compared to that of the ascending aorta. A ratio of
<0.3 usually signifies that primary repair would be
unsuccessful, and a bridging shunt operation may be of
benefit
• Assessment of coronary artery origin is also essential to
surgical planning.
123. Post-surgical complications
• conduction abnormalities
• RBBB: 80-90% of cases
• bifascicular block: 15% of cases
• premature ventricular contractions (PVC): ~50% of cases
• sustained ventricular tachycardias (VT): ~5% of cases
• atrial arrhythmias: common
• valvular dysfunction
• tricuspid regurgitation
• pulmonary regurgitation
124. Tricuspid atresia
• Agenesis of the tricuspid valve and right ventricular inlet
• an obligatory intra-atrial connection through either an ASD
or patent foramen ovale
• Only cyanotic condition associated with LVH
• a/w hypoplastic RV
• Extra cardiac Associations
• right-sided aortic arch
• absent spleen
128. Ebstein anomaly
• Uncommon CHD
• Atrialisation of RV
• the most common cause of congenital tricuspid regurgitation.
• Antenatal: hydrops fetalis and fetal tachyarrhythmias
136. Treatment and prognosis
• Palliative
• closure of the underlying shunt is contra-indicated
• Eisenmenger phenomenon is one of the most severe
manifestations of PAH, the prognosis is better than that
of idiopathic PAH
138. Syndromic association
• Down’s: AVSD>VSD>ASD
• Edward’s: VSD>ASD
• Patau: ASD>VSD
• Noonan: PS> Sub aortic stenosis
• Turner: Bicuspid aortic valve
• Willisam: Supravalvular AS
139. • CASE
A 20years old female presented with shortness of breath,
palpitations, and generalized weakness. On chest auscultation,
ejection systolic murmur heard at the left upper sternal border.
140.
141. CXR findings:
Cardiomegaly with enlarged pulmonary artery and increased
pulmonary vascularity (plethora). Small aortic knuckle.
Echo cardiography confirmed the diagnosis of ASD
153. Take Home massage
• Every 15 minutes a baby born with CHD
• We can cut off the environmental causes by awareness
• Early diagnosis can prevent the complications and decrease morbidity
and mortality.
154.
155. “ Whenever there is a human is need, There’s an
opportunity for kindness and To make a
difference!!”
-Palak Muchhal
Editor's Notes
a patent ductus arteriosus with conical configuration, prominent aortic ampulla and narrow pulmonary end (Krichenko type A)
Patient has history of corrective surgery for Tetralogy of Fallot. There is a stent in the conduit