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Congenital Heart Disease : An Overview
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CONGENITAL HEART DISEASE-AN OVERVIEW
Dr N.C.Joshi
Consultant Pediatrician,
Consultant at Nanavati Hospital,
Ex Dean:-B.J.Wadia Children's Hospital.


CYANOSIS

I. Causes of Cyanosis with Excessive Pulmonary Blood Flow

II. Causes of Cyanosis with Inadequate Pulmonary Blood flow

Pulmonary atresia or severe stenosis with

CONGESTIVE HEART FAILURE

Causes of CCF in 1st week of life :
  • Cardiac causes :

  • Extracardiac causes :

    • A-V malformation

    • Anemia

    • Polycythemia

    • Infant of diabetic mother

Causes of CCF after 1 st week of life

  • In a 2month old :
  • D-transposition of great arteries

  • Between 2months to 6 months of age :

    • Ventricular septal defect

    • Patent ductus arteriosus

    • Endocardial cushion defect

    • Endocardial fibroelastosis

    • Anomalous left coronary artery

    • Left ventricle obstruction

  • Between 6 months to 1 year of age :

    • Endocardial fibroelastosis

    • Ventricular septal defect

  • Between 1 year to 15 years of age :

CYANOTIC CONGENITAL HEART DISEASE

VSD is present in 40% of the cases

D-TGA
  • Usually seen in a large male newborn infant (M/Fis3/1)

  • It may not have a murmur

  • Chest X-ray shows: "egg-shaped heart"(40%)

  • EKG : RVH

  • Treatment:

    • Balloon atrial septostomy (Rashkind's procedure- emergent surgery)

      • Blalock-Hanlon

    • Intra-atrial corrective surgery( at 6-12 mos)

      • Mustard's procedure

      • Senning's procedure

    • Anatomical correction

      • Jatene's operation

    • Total Anomalous Pulmonary Venous Return (TAPVR)

    • Types:

      • Supracardiac (50%)

      • Cardiac (20%)

      • Infracardiac (subdiaphragmatic) (20%)- obstructive

      • Mixed type (10%)

 
 
 
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