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congenital Heart Defects.PDA,ASD,VSD,TGApptx
- 1. P R E PAR E D B Y: R AJ A L A K S H M I . S CONGENITAL HEART DEFECTS
- 4. INTRODUCTION • Congenital heart defects are one of the most common congenital anomalies that may involve chambers, valves, great vessels arising from the heart. Most of the cases case is unknown.
- 13. INCIDENCE • One of the most common defect of the heart • It is twice more common in females as compared to males. • PDA is common in infants who weigh less than 1500gm and accounts for 5- 10 % of all congenital heart disease.
- 14. PATHOPHYSIOLOGY Volume overloaded left ventricles Increased blood return to left side of heart Increased blood flow to pulmonary tree Shunting of blood from high pressure aorta to low pressure pulmonary artery Failure of closure of ductus arteriosus
- 15. CLINICAL FEATURES • Clinical features of PDA depend on the size of PDA and age of infant. • Preterm infants are usually symptomatic earlier. • In preterm infants pulmonary vascular resistance falls more rapidly, allowing more left to right shunting and their myocardium is immature and less able to handle the extra load so they go into congestive heart failure easily.
- 16. • In term infants symptoms depend on the size of ductus. • The term infants with small PDA are usually asymptomatic, whereas those with large PDA may present with congestive heart failure. • These children may have growth retardation and easily fatigability.
- 17. DIAGNOSTIC EVALUATION • Cardiac examination • Electrocardiogram • Chest radiographs • Echocardiogram
- 18. THERAPEUTIC MANAGEMENT • Some PDA will close spontaneously; however preterm infants who are symptomatic and require increasing ventilatory support need early intervention either medical or surgical. • Medical managemnt • Indomethacin • Prostaglandin inhibitor • Surgical management • Thorough lateral thoracotomy • Ductus is either ligated with suture or ligated and divided completetly.
- 21. • Tetralogy of fallot is the most complex congenital heart defect with decreased pulmonary blood flow. It includes a combination of 4 defects: I. ventricular septal defect II. Overridding of aorta III. Pulmonary stenosis IV. Right ventricular hypertrophy
- 23. TOF
- 25. CLINICAL FEATURES • Cyanosis • Clubbing of finger and toe nails occur by 1- 2 years of age • Exercise causes dyspnea • Children assume ‘squatting position’ in between play, as this position relieves dyspnea. • Paroxysmal dyspneic attacks • These children grow and develop normally • They are small and their nutritional status is poor.
- 27. DIAGNOSTIC EVALUATION • Cardiac examination • Electrocardiogram • Chest radiographs • Echocardiogram • Cardiac catheterization
- 29. THERAPEUTIC MANAGEMENT Medical management • Knee chest position • Propranolol • Intravenous prostaglandin E 1 therapy
- 31. Surgical management a) Palliative surgery a) Blalock –Taussing Shunt b) Pott’s Procedure c) Waterston Shunt d) Brock’s Procedure
- 34. COMPLETE D- TRANSPOSITION OF GREAT ARTERIES
- 40. Mustard repair
- 41. RHEUMATIC FEVER
- 42. Pathophysiology