Congenital Heart Disease (1) Flashcards
Congenital heart disease: types
Acyanotic - most common causes
- ventricular septal defects (VSD) - most common, accounts for 30%
- atrial septal defect (ASD)
- patent ductus arteriosus (PDA)
- coarctation of the aorta
- aortic valve stenosis
Congenital heart disease: types
Acyanotic - most common causes
Ventricular septal defect
Ventricular septal defects (VSD) are the most common cause of congenital heart disease. They close spontaneously in around 50% of cases. Congenital VSDs are associated with chromosomal disorders (e.g. Down’s syndrome, Edward’s syndrome, Patau syndrome) and single gene disorders such as Non-congenital causes include post myocardial infarction
Features
classically a pan-systolic murmur which is louder in smaller defects
also described as a holosystolic murmur heard at the left sternal border
Complications
- aortic regurgitation*
- infective endocarditis
- Eisenmenger’s complex
- right heart failure
- pulmonary hypertension: pregnancy is contraindicated in women with pulmonary hypertension as it carries a 30-50% risk of mortality
Congenital heart disease: types
Acyanotic - most common causes
Ventricular septal defect
Symptoms
Congenital heart disease: types
Acyanotic
Atrial septal defects
Atrial septal defects (ASDs) are the most likely congenital heart defect to be found in adulthood. They carry a significant mortality, with 50% of patients being dead at 50 years. Two types of ASDs are recognised, ostium secundum and ostium primum. Ostium secundum are the most common
Features:
- ejection systolic murmur, fixed splitting of S2
- embolism may pass from venous system to left side of heart causing a stroke
Ostium secundum (70% of ASDs):
- associated with Holt-Oram syndrome (tri-phalangeal thumbs)
- ECG: RBBB with RAD
Ostium primum:
present earlier than ostium secundum defects
associated with abnormal AV valves
ECG: RBBB with LAD, prolonged PR interval
Congenital heart disease: types
Acyanotic
Atrial septal defects
Symptoms
