CONGENITAL HEART DISEASE

By
Dr.Enas Abdalla Saeed
MD of pediatrics and child health
 What is congenital heart disease?

 Its structural defect of the heart that present at

birth, symptoms and signs depend on the type of the
defect.

 What are the common causes of congenital heart

disease?

1- primary genetic factors 10%

2- environmental factors 3% to 5%
3- multifactorial 85%
Epidemiology :-

 it occurs in 0.5- 0.8%

 Incidences are higher in :-

• Stillborn 3-4%

• Abortuses 10-25%

• Premature infants 2%
TYPES OF CONGENITAL HEART DISEASE
 1- Acyanotic CHD “left to right shunt”
 *PDA *VSD *ASD *aortopulmonary window

 2- Cyanotic CHD “right to left shunt”

• TOF *TGA *pulmonary atresia
• Ebstein anomaly

 3- mixed shunts “blue & breathless”

* Complete AVSD *tricuspid atresia
 4- obstructive lesions :-
*Aortic stenosis *pulmonary stenosis
*vascular ring and sling.

 Coarctation of the aorta

 Hypoplastic left heart syndrome
 Critical aortic stenosis
 Interruption of aortic arch
 Total anomalous pulmonary venous connection
PDA :-
 Failure of ductus
arteriosus to close at
birth.
 Usually asymptomatic,
rarely may present with
heart failure.
 Continuous machinery
murmur.
 ECG & CXR usually
normal, unless it is very
large.
 Treatment :-

Cardiac catheter at 1year.

Surgical ligation at 1-
3month if it is large.
 VSD :-
*Defect anywhere in the
ventricular septum, it can
be small or large.
• There is 2 types.
• Small is asymptomatic
in 80-90% with normal
CXR & ECG,it might
close spontaneously.
• Large present with
heart failure in the first
week of life.
• There is CXR and ECG
finding.
• Management of heart
failure, surgical closure
at 3-5months.
ASD:-
Defect occurs at any
portion of atrial septum.
• Types :-

1-secendum ASD.
2-primum ASD.
3-sinus venosus.
 ASD ASD primum Sinus
secundum nenosus ASD
Defect site Center of the Lower atrial Upper end of
septum septum atrial septum
involving fossa
ovalis
C/F Asymptomatic Asymptomatic Asymptomatic
80% of ASD 10% of ASD or heart failure
Murmur Fixed spitting
S2.
ECG RBBB + superior axis RBBB
RVH RVH

CXR Increased Increased +cardiomegaly

pulmonary pulmonary
vascular vascular
marking marking

management 3-5 years 3-5years 1-5years

90% through All need Surgical
catheter surgical closure closure
 Tetralogy of fallot
“TOF”
It consist of
1-VSD.
2-subpulmonary stenosis.
3-overriding of the aorta.
4-RVH.
*usually asymptomatic at
birth, it worsen when the
get older.
ECG: RVH.
CXR: boot shape heart,
Oligemic lung field.
Treatment:
BT shunt
Elective repair 6-
9months.
 Transposition of the great
arteries “TGA” :-
Aorta is connected to RV and
pulmonary artery connect to
LV.
Duct dependent lesion
May be associated with other
CHD.
ECG: normal
CXR : may be normal, egg on
side.
Treatment: -atrial balloon
septostomy
Atrial switch operation.
Ebstein anomaly:
*malformed tricuspid
valve set further into
right ventricle.

Cyanosis & loud murmur

ECG:superior axis.
CXR: wall to wall heart
Oligemic lung field.
management:
Resuscitation
Pulmonary vasodilator
Pulmonary atresia :-
Duct Pulmonary
dependent atresia with
VSD and
collaterals
C/f Cyanosis Usually present
Usually no with heart
murmur failure at
1month
ECG normal Biventricular
hypertrophy
CXR Normal at birth Boot shape heart
Boot shape Cardiomegaly
Oligemic lung
field
management Resuscitation Management of
BT shunt failure
Radiofrequency Staged surgical
perforation if repair
appropriate
ANY QUESTIONS

Thank you