CONGENITAL HEART DISEASE in children(DONE).ppt

heart diseases

1. CONGENITAL HEART DISEASE
PRESENTER
O. MALIYAMA

2. OBJECTIVES
•Introduction
•Acyanotic Congenital Heart Disease
•Cyanotic Congenital Heart Disease
•Presenting Symptoms in the Neonate

3. INTRODUCTION
•Congenital Heart Disease are divided into 2
major groups
1.Acyanotic Congenital Heart Disease
2.Cyanotic Congenital Heart Disease

4. INTRODUCTION CT…
•The incidence of congenital heart disease is 8 per
1000 live births. Major cause of congenital heart
diseases are lesions
•The spectrum of lesions range from
asymptomatic to fatal
•Although most cases of congenital heart disease
are due to multiple factors not lesions only
•Some causes are associated with chromosomal
disorders such as single gene defects, teratogens
or maternal metabolic disease

5. INTRODUCTION CT…
•Congenital heart defects can be divided into
three broad pathophysiologic groups:
1. Left-to-right shunts
2. Right-to-left shunts
3. Obstructive stenotic lesions

6. Acyanotic congenital heart
disease
•Acyanotic congenital heart disease includes left-to-
right shunts resulting in an increase in pulmonary
blood flow and obstructive lesions which usually
have normal pulmonary blood flow.
-The most common left-to-right shunts are
Ventricular Septal Defects (VSD), Atricular Septal
Defects (ASD) and Pattent Ductus Ateriosus (PDA)
-All three groups mentioned above have normal
systemic oxygen saturations in the presence of
excessive pulmonary blood flow

7. Acyanotic congenital heart disease
ct…
-Acyanotic congenital heart disease includes left-to-
right shunts resulting in an increase in pulmonary
blood flow and obstructive lesions which usually
have normal pulmonary blood flow.
-The most common left-to-right shunts are
Ventricular Stenosis Defects, Atricular Strnosis
Defects and Pulmonary Defects or Atracia
-All three groups mentioned above have normal
systemic oxygen saturations in the presence of
excessive pulmonary blood flow

8. Cyanotic congenital heart disease
•Cyanotic congenital heart disease occurs when some of the
systemic venous return crosses from the right heart to the
left and goes back to the body without going through the
lungs (right-to-left shunt)
•Cyanosis, the visible sign of this shunt occurs when
approximately 5g/100 mL of reduced hemoglobin is present
in systemic blood
• The patient's hemoglobin level determines the
presentation of clinical cyanosis
• A polycythemic patient appears cyanotic with a lower
percentage of reduced hemoglobin whereas a patient with
anemia requires a higher percentage of reduced
hemoglobin for the recognition of cyanosis

9. Cyanotic congenital heart disease
ct…
•The most common cyanotic congenital heart defects
are the 5 "Ts": tetralogy of Fallot, transposition of the
great arteries, tricuspid atresia, truncus arteriosus and
total anomalous pulmonary venous return.
•Other congenital heart defects that allow complete
mixing of systemic and pulmonary venous return can
present with cyanosis depending on how much
pulmonary blood flow is present
• Many cyanotic heart lesions present in the neonatal
period

10. Presenting Symptoms in the Neonate
•Cyanosis with respiratory distress
•due to increased pulmonary blood flow
caused by transposition with or without
associated lesions
•Cyanosis without respiratory distress
•Due to Decreased pulmonary blood flow
caused by Right heart obstruction due to
Tricuspid atresia
• 

11. Presenting Symptoms in the Neonate
ct…
•Hypoperfusion
•Poor cardiac output due to Poor cardiac function
Left heart obstruction Total anomalous
pulmonary venous return with obstruction Aortic
stenosis Hypoplastic left heart syndrome
Cardiomyopathy Normal anatomy
Cardiomyopathy, Myocarditis
•Respiratory distress with desaturation (not
visible cyanosis)
•Bidirectional shunting, Complete mixing, Truncus
arteriosus

12. GROUP PRESENTATIONS
•Pulmonary stenosis (PS), Atrial Septal Defect (ASD) and Pericarditis
(Group 1)
•Ventricular Septal Defect (VSD) and Atrioventricular Canal (AVC) (Group 2)
• Patent Ductus Arteriosus (PDA) and Endocardial Cushion Defect (ECD)
(Group 3)
•Aortic Stenosis (AS) and Coarctation of the Aorta (COA)
•Tetrology of Fallot (TF) and Trasposition of Great Arteries (TGA) and
Trucuncus Arteriosus (TA) (Group 4)
• Tricuspid Atresia (TA) and Hypoplastic Left Heart Syndrome (HLHS)(Group
5)
•Haematological Dysfunction and Hypertension (Group 6)
•Due date any time there will be space within theory period