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CHD Final 1
CHD Final 1
CHD Final 1
CONGENITAL HEART DEFECT – anatomic abnormalities present at birth that results in abnormal cardiac
function
Acquired heart disorder- the disorder happens after birth, after infection or autoimmune
Review:
1.Right atrium
2.Triscupid valve
3.Right ventricle
4.Pulominic valve
5.Left atrium
6.Mitral valve ( bicuspid valve)
7.Left ventricle
8.Aortic valve
1.The deoxygenated blood comes from superior and inferior vena cava
2Will go to the right atrium the will go to tricuspid valve
3.Then go to pulmonic valve, the pulmonary artery (deoxygenated blood) to the lungs
4.The return by the pulmonary veins (oxygenated blood) going to left atrium
5.Then go inside the left ventricle through mitral valve then left ventricle, aortic valve going to the aorta
and distribute to the body
Video:
Veins- towards heart
Arteries away from the heart
1.INC/SVC
2.RA
3. Tricuspid valve
4.RV
5.Pulmonic
6.Pumonary artery
7.Lungs
8.Lungs
9.Pulmonary veins
10.LA
11.Mitral
12.LV
13.Aortic
14.Aorta
T P M A- toilet paper my assets
Hemodynamics
•As blood is pumped through the heart
1.Flows from an area of high pressure to one of low pressure
2.Takes the path of last resistance
•The higher the pressure of the gradient, the faster the rate of flow
•The higher the resistance, the slower the rate of flow
•Normally:
1.Pressure on the right side of the heart is lower than the left side
2.Resistance in the pulmonary circulation is less than that in the systemic circulation
•Pulmo- less resistance
•Systemic high resistance
Video:
- This causes some red blood to mix with blue blood in the right ventricle
- VSDs are often first detected as heart murmurs when a doctor examines a child
- the treatment depends on the other factors as well
Video:
A newborn with extreme pulmonary stenosis present an emergency situation because the
right ventricle cannot eject sufficient blood to pulmonary artery to maintain normal oxygen
level
Balloon dilation – surgery
CYANOTIC TYPE
A. TRANSPOSITION OF GREAT VESSELS
✓ Aorta arises from right ventricle (nakabit sa apulmonary artery), pulmonary artery arises from
left ventricle (dapat sya aorta) oxygenated blood therefore circulates through left side of
heart to lungs and back to left side
✓ unoxygenated blood enters the right atrium from body ,goes back to right ventricle and back to
circulation without being oxygenated
S/S:
Blueness of the skin
Shortness of breath
Poor feeding
Clubbing of the fingers or toes
peripheral hypoxemia
severe progressive pulmonary hypertension.
Complications:
Arrythmias
Heart failure
Mgt: Balloon Atrial Septostomy (Rashkind Procedure)
Video:
Oxygen poor (blue) blood goes to the body via the aorta
Oxygen-rich (red) blood goes back to the lungs via the pulmonary artery
1.Aorta and pulmonary artery are connected to the wrong ventricles
2.Deoxygenated blood is pumped back to the body
B. TETRALOGY OF FALLOT
an abnormal opening, or ventricular septal defect, that allows blood to pass from the
right ventricle to the left ventricle without going through the lungs
a narrowing (stenosis) at or just beneath the pulmonary valve that partially blocks the
flow of blood from the right side of the heart to the lungs
Tetralogy of Fallot results in cyanosis (bluish color of the skin and mucous membranes due to
lack of oxygen).
First presentation may include poor feeding, fussiness, tachypnea, and agitation.
Hypoxic "tet" spells are potentially lethal, unpredictable episodes that occur even in
noncyanotic patients with TOF. These spells can be aborted with relatively simple procedures.
Birth weight is low.
Growth is retarded.
Squatting position
Scoliosis - Common
Retinal engorgement
Hemoptysis
Video:
VSD
Overriding aorta
Pulmonary stenosis
Right ventricular
Hypertrophy