Elevated pressures and Atrial Septal Defect dilation of right atrium and (ASD) ventricle

L-R (Acyanotic)

Ventricular Septal Defect (VSD)

All chambers may dilate due to increased pressure of RV & increased return to LV LV dilation can lead to heart failure Common in Downs

L-R (Acyanotic)

R-L reversal Eisenmenger Prolonged, severe shunt (L-R from VSD) can cause increased pulmonary resistance and reversal of shunt (cyanotic)

Patent Ductus Arteriosus (PDA)

May cause LV dilation due to increased return May lead to heart failure

L-R (Acyanotic)

None if minor (Acyanotic) Aortic Stenosis High LV systolic pressures Low post stenosis pressure LV hypertrophy R-L via ductus (severe) May have R-L foramen ovale (Severe) (Cyanotic) No shunt (postductal) Coarctation of the Aorta Similar effect on LV as stenosis Usually after brancing to head and upper extremities Ductus may remain open (preductal) Constriction great enough may cause R-L (cyanosis)

Pulmonic Stenosis

High RV pressures RV hypertrophy Less than 50 mmHG gradient considered mild

(backup into RA) R-L shunt through ASD due to elevated R atrial pressures

Tetralogy of Fallot

VSD RV hypertrophy Aorta positioned over incomplete septal wall Pulmonic stenosis

R-L (Cyanotic)

Transpotion of the Great Vessels

Can only sustain life for a short period which is extended if patent ductus or foramen ovale allowing mixing of oxygenated and deoxygenated blood

Pulmonary veins to LV to lungs to LV (Cyanotic)