Fetal Congestive Heart Failure .pptx

fetal heart failure

1. Fetal Congestive Heart Failure Dr. Ajeet Kumar Mishra Chief Consultant Pediatrician and Pediatric Cardiologist Niko Children’s Hospital Chitwan

2. Causes

3. Parameters

4. Basics of Fetal Cardiac Function Fetal Circulation 3 Shunts (DV, PFO, DA) Low Resistance Capacitor (Placenta) Parallel Circulation Complicated by monochorionic twinning Less contractile elements, more non-contractile elements Diastolic dysfunction more common and serious Systolic function difficult to assess, better tolerated

5. Global Function MPI(Myocardial Performance Index ) ICT+IRT/ET Cursor placement between inflow and outflow Flow alignment necessary Standardized values Can be performed independently for RV and LV Values more than 0.48 impaired function Does not differentiate between systolic and diastolic dysfunction Load Dependent

6. Diastolic Function AV valve Inflow Pattern: 2 components E- Passive ventricular Filling(Small) A- Atrial Contraction(Tall) E/A Ratio Becomes monophasic with dysfunction Load dependent

7. Systemic Venous Pressure Diastolic function assessment Sequential changes IVC>DV>UV Normal flow mildly phasic continuous flow

8. DV

9. Systolic Function Fractional Shortening Ejection Fraction Load dependent Circumferencial function

10. Ejection Fraction

11. TDI Longitudinal Function Relatively Load Independent

12. Cardiovascular Profile Score

13. Thank You