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Congenital Heart Disease (Etiology (Genetic disorder (chromosomal defect,…
Congenital Heart Disease
Definition: malformation of heart, aorta, or other large blood vessel that are present since birth
Risk factor: chromosome defect, pregnant and smoking/alcohol consumption, drug abuse during pregnancy, diabetes mellitus, obesity
Epidemiology: CHD happen mostly in asia, and VSD is the highest prevalence of CHD.
Etiology
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Maternal factors
Health, medical disease, drug abuse
Environmental factors
organic solvents, paints, etc
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Pathophysiology
Patent Ductus Arteriosus
ductus arteriosus does not closed in postnatal baby (due to factor such as prostaglandin) --> causing blood flow to move down the pressure gradient causing preload of left heart chamber
Atrial Septal Defect
the right and left atrium are connected by shunt. this is classified based on location of shunt; secandum ASD, primum ASD, sinus venosus ASD
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Eisenmenger Syndrom
if VSD is not treated properly, it could profress into this syndrome, changing the direction of blood into right to left due to pulmonary hypertension
Examination
Physical/anamnesis
newborn: have symptoms of iritability, rapid breathing, cyanosis, inconsolable crying
Todlers: cyanosis, fluid retension, changes in pulse rate, pale/cool limbs
Adulthood: weakness, fatigue, shortness of breath, history of GD delay, cyanosis
Auscultation: murmur, squishing, clicks, irregular beats
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specific for VSD
common ways: cardiac catheterisation, auscultation of heart sound (holosystolic, mid diastolic murmur), ECG, chest radiography
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Radiology and ECG
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with TOF, patient need to do echocardiography every 12 month until patient's age is 10 yo
CMR and Echo imaging are recommemded in patient with severe CHD and moderate to severe valve dysfunction
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Treatment
Medical treatment
Initial (PGE, Indometachin)
complication (anti-failure, anti-spell)
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Palliative treatment
Intervention non-surgery (BAS, PDA stenting)
Surgery (BT shunt, PA banding)
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