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Acyanotic CHD (left-to-right shunts) - Coggle Diagram
Acyanotic CHD (left-to-right shunts)
ASDs
VSDs
Persistent Ductus Arteriosus (PDA)
connects pul art to descending aorta
in term infants normally closes shortly after birth
= failure to close by 1mo after expected date of delivery, now flow from aorta to pul art due to fall in pul vasc resistence after birth
due to defect in constrictor mechanism of duct
In premies not due to CHD, due to prematurity
clinical features
continuous murmur beneath left clav
pulse pressure increased - causes collapsing/bounding pulse
unusual to have sx
if duct large can cause pul HTN + HF
investigations
CXR + ECG usually normal
if large than CXR will be indistinguishable from large VSD
duct readily identified on ECHO
tx
closure recommended to abolish lifelong risk of bacterial endocarditis + pul vasc disease
closure with coil or occlusion device @ 1y/o
occasionally surgical ligation required
Eisenmenger syndrome
high pul flow due to untxed large left-to-right shunt - increased pul vasc resistance
@ 10-15 y/o shunt reverses - cyanosis in teen
progressive - adult will de of right HF in 4th/5th decade of life
aim = prevent this
transplant not easily available