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Congenital heart disease (Ventricular Septal Defect (VSD) (Laboratory…
Congenital heart disease
- structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance.
- third prevalent congenital malformation, and remains the most frequent cause of death in infants and children borne with a structural anomaly.
- The incidence is about 12 per 1000 live births (1,2%).
- Spectrum of congenital heart disease:
VSD 31 - 42 % / ASD 8 - 12 %
AS 7-8% / PS 6 - 12 %
CoAo 5-6%
TGA 5% / PDA 4-5%
HLHS 4-5% / ToF 3-6%
Division
- Simple ( PDA, VSD, AS, PS ) / Complex ( Fallot Tetralogy, single ventricle, tricuspid atresia)
- MILD (asymptomatic for many years) / SEVERE (symptoms observed in fetal live or just after birth)
- With intracardiac or intravessel leak [increased pulmonary flow (VSD, ASD, PDA) or decreased pulmonary flow (ToF)] / Without leak (CoAo, valvular heart disease: AS, PS, MS, MI)
- Duct dependent pulmonary flow (PS-critical, PA, TA) / Duct dependent systemic flow (AS-critical, CoAo, HLHS) / Duct dependent blood mixing (TGA, complex CHD)
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ASD
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- Ostium primum type is associated with Down syndrome
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- Defects with left-to-right shunting may be relatively asymptomatic at birth, but the shunt can eventually reverse.
Increased flow through the pulmonary circulation results in hypertrophy of pulmonary vessels and pulmonary hypertension.
Increased pulmonary resistance eventually results in reversal of shunt, leading to late cyanosis (Eisenmenger syndrome) with right ventricular hypertrophy, polycythemia, and clubbing.
- Defects with right-to-left shunting usually present as cyanosis shortly after birth.