Congenital heart

diseases
BY NUR FATIN NAJWA ROSLINORAZAM
Contents

Atrial septal defect (ASD)

Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
Coarctation of aorta (COA)
Tetralogy of Fallot (TOF)
 Atrial septal defect (ASD)

ASD : a hole connects the atria (form at the interatrial septum)

Results in shunting down of blood from left to right atrium and then to the right ventricle
and pulmonary arteries.

As a results there is gradual enlargement of the right side of the heart and pulmonary
arteries.

There may be pulmonary hypertension,cyanosis,arrhythmia,haemoptysis and chest pain.

ASD (Clinical features)

Usually asymptomatic
Physical signs :wide fixed splitting of the 2nd heart sound and systolic
flow murmur over pulmonary valve
Investigations

CXR
ECG
Echocardiography

MANAGEMENT
-Surgery
Ventricular septal defects (VSD)

A hole that connect the ventricles

The oxygen-rich blood then gets pumped back to the lungs instead of
out to the body, causing the heart to work harder.
A small ventricular septal defect may cause no problems, and many
small VSDs close on their own. Larger VSDs need surgical repair early in
life to prevent complications.
Clinical features

Ventricular septal defect symptoms may include:

Poor eating, failure to thrive
Fast breathing or breathlessness
Easy tiring
In auscultation pansystolic murmur can be heard.
Patent ductus arteriosus (PDA)

During fetal life,before lungs begin to function,most of the blood from

the pulmonary artery passes through the ductus arteriosus into aorta.

Normally the ductus closes soon after birth but sometimes it fails to do
so.

Since the pressure of aorta is higher than pulmonary artery there will
be continuous left to right shunt.
Clinical features

Asymptomatic/Silent
Dyspnea usually the first symptoms
A continuous machinery murmur is heard
Coarctation of aorta

COA : Narrowing of the descending aorta

Clinical features

Radiofemoral delay/Radioradial delay

Weak femoral pulse
Increase BP
Systolic murmur
Investigations

CXR
CT-angio

MANAGEMENT
-Surgery/balloon dilatation/stenting
Tetralogy Of Fallot (TOF)

Most common cyanotic congenital heart disorder

The 4 features typical TOF :

1.Ventricular septal defect (VSD)
2.Pulmonary stenosis
3.Right ventricular hypertrophy
4.Overriding aorta
 Clinical features
In children:
-Cyanosis
-Restless and agitated,cry inconsolably
-Toddlers may squat
-Difficulty in feeding
-Failure to thrive
-Clubbing

In adult:
-Usually asymptomatic
Dyspnea
Palpitation
Investigations

CXR
ECG
Echocardiography
Cardiac CT & MRI
Management

Give oxygen
Knee-chest position
Morphine
B-blockers
Endocarditis prophylaxis
Surgery is the only cure.
THANK YOU!