ASD:

Left to right shunt

Secundum ASD : septum secundum
Primum: AV valves
Sinous venosis: SVC
Murmus, no cyanosis, pulmonary art inc R and P and V ,
vasocons, rarely HF

Foramen ovale:
No septal defect, only patent
If it is patent, it will open upon high pressure from right
like in bowel movement/coughing, first blood volume
decreases then increases suddenly and greatly so inc RA
pressure--> r-l shunt for few seconds
VSD:
Membranous and infundibular
Left to right shunt, RV kteer 3ale P w volume sar fiya ,
pulmonary hypertension--> RV pressure inc--> right to
left--> mix oxygenate with deoxygenated--> to peripheral
tissues--> cyanosis
Patent ductus arteriosis
Btwn pulmonary trunk and arch of aorta lzm tsaker,
bedal maftu7a [intrauterine life , blood pass from pulm
artery to aorta][cz no lung]
MACHINARY LIKE MURMUR , no cyanosis
Left to right , if large shunt then obstructive pulmonary
vascular disease
RIGHT TO LEFT SHUNTS:
TETROLY OF FALLOT:
The four cardinal features of TOF are:
1. VSD
2. obstruction of the right ventricular outflow tract
(subpulmonic stenosis)
3. aorta that overrides the VSD
4. right ventricular hypertrophy
BOOT SHAPED HEART
Boot shaped heart due to hypertrophy of RV
Stenosis of pulmonary valve--> inc RV pressure--> R-L
shunt -> cyanosis
If COMPLETE ATRASIA[CLOSURE OF VALVE]:
Stenosis of pulmonary valve--> inc RV pressure--> R-L
shunt -> cyanosis
Transposition of great arteries:
Pulmonary trunk tali3 from LV and aorta from RV
RV hypertrophied to supply systemic circulation
LV hypoplastic/atrophic
Without surgery patient dies within few months
Tricuspid atresia:
Btwn RA and RV, hypoplasia for RV
Right to left shunt , close of tricuspid
Coarctation of aorta:
More in males and females with turner syndrome
( different pulses in arms and lower limbs)
Pulmonary Stenosis and Atresia:
Closed pulmonary valve, PDA allows passage from aorta
to pulmonary artery

If complete closure: hypoplastic RV, also associated with

ASD to help blood pass form RA- to LA
If stenosis: mild, lives asymptomatically
Aortic stenosis/Atresia:
Leads to obstruction of LV outflow--> LV
hypoplasia/atrophy

Is mild stenosis: LV hypertrophy like usual stenosis sand

lives normally. May damage conduction of heart-->
sudden cardiac death by arrhythmia

If closed completely: blood cant pass to aorta and severe

symptoms upon birth

Can occur: valvular, subvalvular, supravalvular