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Main » 2010 » July » 18 » Short note about congenital heart disease
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Short note about congenital heart disease
TYPE
Cyanotic 
A cyanotic
1-right and left shunt e.g VSD
2-aortic stenosis
3-pulmonary stenosis                        
1-fallots tetralogy             
2-right and left shunt e.g:esenmenger's vsd


A-- CYANOTIC


1-Ventricular septal defect (VSD)

Definition


A ventricular septal defect (VSD), also called a hole in the heart, is a common heart defect that's present at birth (congenital).

A baby with a small ventricular septal defect may have no problems. A baby with a larger ventricular septal defect or associated heart defects may have a telltale bluish tint to the skin — due to oxygen-poor blood — often most visible in the lips and fingernails

Fortunately, ventricular septal defect is readily treatable. Smaller ventricular septal defects often close on their own or don't cause problems. Others need surgical repair, sometimes not until the condition is first detected or symptoms first develop in adulthood. Many people with ventricular septal defects have normal, productive lives with few related problems.

haemodynamic
A ventricular septal defect is an abnormal opening between the heart's lower pumping chambers. It's a common congenital heart defect that may heal on its own or require treatment to repair.


1-left ventricular volume over load
2-systolic flow from left ventricular to right ventricular  through VSD
3-Lung plethora
4-pulmonary vaso constriction -->pulmonary hypertension


Symptoms


Signs and symptoms of serious heart defects often appear during the first few days, weeks and months of a child's life.



Signs and symptoms of a large ventricular septal defect in a baby may include:

  • A bluish tint to the skin, lips and fingernails (cyanosis)
  • Poor eating, failure to thrive
  • Fast breathing or breathlessness
  • Easy tiring
  • Swelling of legs, feet or abdomen
  • Rapid heart rate

Although these signs can be caused by other conditions, they may be due to a congenital heart defect.

You and your doctor may not notice signs of a ventricular septal defect at birth. If the defect is small, symptoms may not appear until later in childhood — if ever. Signs and symptoms vary depending on the size of the hole. Your doctor may first suspect a heart defect during a regular checkup while listening to your baby's heart with a stethoscope.

Sometimes a ventricular septal defect isn't detected until a person reaches adulthood and develops signs or symptoms of heart failure, such as shortness of breath.

When to see a doctor
Call your doctor if your baby or child:

  • Tires easily when eating or playing
  • Is not gaining weight
  • Becomes breathless when eating or crying
  • Has a bluish tint to his or her skin, especially around the fingernails and lips
  • Breathes rapidly or is short of breath

Call your doctor if you develop:

  • Shortness of breath when you exert yourself or when you lie down
  • Rapid or irregular heartbeat
  • Fatigue and weakness
  • Swelling (edema) in your legs, ankles and feet

Risk factors

Having the following conditions during pregnancy can increase your risk of having a baby with a heart defect.

  • Rubella infection. Becoming infected with rubella (German measles) while pregnant can increase the risk of fetal heart defects. The rubella virus crosses the placenta and spreads through the fetus' circulatory system damaging blood vessels and organs, including the heart.
  • Poorly controlled diabetes. Uncontrolled diabetes in the mother in turn affects the fetus' blood sugar, causing various damaging effects to the developing fetus.
  • Drug or alcohol use or exposure to certain substances. Use of certain medications, alcohol or drugs or exposure to chemicals or radiation during pregnancy can harm the developing fetus.
Treatment
1-Small-followup discontinues closure
2-early surgical closure

2-
Pulmonary valve stenosis

Definition


Pulmonary valve stenosis is a condition in which the flow of blood from your heart to your lungs is slowed by a deformed pulmonary valve, or a deformity above or below the valve.


Haymodynamic

In pulmonary stenosis, the flow of blood from the right ventricle to the pulmonary artery is obstructed by narrowing at the pulmonary valve. The greater the constriction, the harder the right ventricle must pump to get blood into the pulmonary artery.


1-pulmonary stenosis--------> right ventricular pressure
2-pressure grading between right ventricular and pulmonary artery
3-pressure over load on right ventricle ---->right ventricle hypertrophy
NB:the intensity of murmur is directly proportional to severity of pulmonary stenosis

Symptoms


Pulmonary valve stenosis symptoms may include:

  • Heart murmur (an abnormal whooshing sound heard using a stethoscope, caused by turbulent blood flow)
  • Shortness of breath, especially during exertion
  • Chest pain
  • Loss of consciousness (fainting)
  • Fatigue

Pulmonary valve stenosis symptoms vary, depending on the extent to which the valve is obstructed. People with mild pulmonary stenosis might have symptoms only while exercising or have none at all. 


When to see a doctor
Talk to your doctor if you or your child experiences the following:

  • Shortness of breath
  • Fainting
  • Chest pain
If you have pulmonary stenosis or another heart problem, prompt evaluation and treatment can help reduce your risk of complications

Risk factors

Because most causes of pulmonary valve stenosis develop before birth, there aren't many known risk factors. However, certain conditions can increase your risk of developing pulmonary valve stenosis, including:

  • Carcinoid syndrome
  • Rheumatic fever
  • Noonan's syndrome

Tretment
none surgical -->ballon dilatation

3-Aortic valve stenosis

Definition


Aortic valve stenosis — or aortic stenosis — occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from your heart into your aorta and onward to the rest of your body.

When the aortic valve is obstructed, your heart needs to work harder to pump blood to your body. Eventually, this extra work weakens your heart and limits the amount of blood it can pump, leading to symptoms, such as fatigue and dizziness





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