Congenital heart defects (CHD) occur in approximately 0.8% of live births and are a leading cause of death in children with congenital malformations. The etiology is primarily unknown and likely involves a mix of genetic and environmental factors, requiring careful evaluation through history, physical examination, and diagnostic imaging. Classification of CHD includes structural defects, cardiomyopathies, and arrhythmias, with final diagnosis confirmed via echocardiography, CT, MRI, or cardiac catheterization.

1. Congenital Heart
Defects
By: Mohammed H.
Supervised by Asst. Prof. Dr. Kawes zangana
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2. OUTLINES
Overview
Fetal VS neonatal circulation
Etiology
How to approach
Evaluation and Classification
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3. OVERVIEW
CHDisease occurs in 0.8% of live births.
(3-4%) stillborns, (10-25%) spontaneous abortuses, and 2% premature infants.
CHD remains the leading cause of death in children with congenital
malformations.
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4. CLASSIFICATION OF CHD
Structural heart defects
Cardiomyopathies
Arrhythmias
>> Is a gross structural abnormality of the
heart or intrathoracic great vessels
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5. Fetal VS normal circulation
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6. ETIOLOGY
**Unknown
Multifactorial and result from a combination of genetic predisposition and an as-
yet-to-be-determined environmental stimulus
Chromosomal abnormalities
Adverse maternal conditions
Gender
Race
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7. APPROACH to CHD
History:
Physical Examination:
General Inspection:
Upper Limbs
Head and Neck
Chest
Abdomen
Lower Limbs
History of poor feeding, sweating, poor weight
gain, exercise intolerance, respiratory distress,
cyanosis
Family history of CHD
Maternal history of diseases, drug intake, alcohol
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8. Evaluation and CLASSIFICATION
Involves 3 major components:
1- Presence or absence of Cyanosis
2- Chest roentgenogram
3- Electrocardiogram
increased
pulmonary vascular markings: normal,
decreased
Right VENTRICULAR
Left VENTRICULAR Hypertrophy
Biventricular
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9. Acyanotic Cyanotic
Increased PBF Normal PBF
RVH LVH RVH LVH
ASD
PAPVR
PS
MS
VSD
PDA
AVSD
AS
COA
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10. Acyanotic Cyanotic
Decreased PBF Increased PBF
RVH LVH RVH BVH
TOF
PA/VSD
DORV/PS
TGA/VSD/PS
TGA
TAPVR
DORV
HLHS
Tricuspid atresia
PA/IVS
Truncus
Arteriosus
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11. CLASSIFICATION cont’d.
*Murmur
The final diagnosis is then confirmed by echocardiography, CT or MRI, or
cardiac catheterization.
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12. REFERENCES:
1-Nelson textbook of pediatrics 20th edition
2-Friedman WF, et al. “Congenital Heart Disease in Infancy and Childhood”, In Heart Disease A
Textbook of Cardiovascular Medicine..6th ed. Ed By Braunwald et al.WB Saunders Company
Philadelphia London New York StLouis Sydney Toronto. 2001:1505-91.
3- Oxford handbook of pediatrics
4- manual of neonatal care
5-Pediatric review
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