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Congenital heart disease - Coggle Diagram
Congenital heart disease
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Patent ductus arteriosus
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excess fluid retention, declining myocardial contractility stemming from chronic volume overload, and arrhythmias contribute to development of CHF
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Treatment and prognosis
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if ductus not closed, prognosis depends on size and level of pulmonary vascular resistance
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Subaortic stenosis
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the obstructive lesion develops during the first several months of life, and there may be no audible murmur at an early age
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The severity of the stenosis determines the degree of LV pressure overload and resulting concentric hypertrophy
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clinical sequelae
arrhythmias
this is due to the increased systolic pressures compromising coronary perfusion and the resulting myocardial ishaemia can lead to arrhythmias
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Functional LV outflow murmurs that are not associated with SAS are common in normal Greyhounds and boxers
Diagnosis
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Echocardiography
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systolic anterior motion of the anterior mitral leaflet and mid systolic partial aortic valve closure suggest concurrent dynamic LV outflow obstruction
ascending aorta dilation, aortic valve thickening, LA enlargement with hypertrophy may also be seen
Doppler
systolic turbulence originating below aortic valve and extending into aorta, as well as high peak systolic outflow velocity
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Treatment and prognosis
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medical therapy with a beta blocker is advocated in patients with moderate-severe SAS to reduce myocardial oxygen demand and minimise the frequency and severity of arrhythmias
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prophylactic antibiotic therapy for animals with SAS before any procedures with potential to cause bacteraemia e.g. dentistry
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Pulmonic stenosis
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many asymptomatic when diagnosed, but RCHF, or hx of exercise intolerance or syncope may exist
stenosis of PV causes a pressure overload of the right ventricle and right ventricular hypertrophy results
as patient gets older, the RV hypertrophy may cause infundibular narrowing of the right ventricular outflow tract
exacerbates pressure gradient, with a dynamic component
the higher the pressure gradient across the stenotic area, the worse the prognosis
murmur is left sided, cranial (third intercostal space) and ventral, radiating dorsally
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