1. Treatments
1.1. medicines may be used to: Help blood flow through the heart (prostaglandins) Help the heart beat stronger Prevent clots (blood thinners) Remove excess fluid (water pills) Treat abnormal heartbeats and rhythms
1.1.1. Percutaneous balloon pulmonary dilation (valvuloplasty) may be performed when no other heart defects are present.
1.1.2. This procedure is done through an artery in the groin.
1.1.3. The doctor sends a flexible tube (catheter) with a balloon attached to the end up to the heart. Special x-rays are used to help guide the catheter.
1.1.4. The balloon stretches the opening of the valve.
2. Effects & Symptoms
2.1. Abdominal distention
2.2. Bluish color to the skin (cyanosis) in some people
2.3. Poor appetite
2.4. Chest pain
2.5. Fainting
2.6. Fatigue
2.7. Poor weight gain or failure to thrive in infants with a severe blockage
2.8. Shortness of breath
2.9. Sudden death
3. Tetralogy of Fallot
3.1. Most Common Cyanotic Heart Diseases
3.1.1. Tetralogy of Fallot causes low oxygen levels in the blood. This leads to cyanosis (a bluish-purple color to the skin).
3.1.1.1. The classic form includes 4 defects of the heart and its major blood vessels:
3.1.1.2. Ventricular septal defect (hole between the right and left ventricles)
3.1.1.3. Narrowing of the pulmonary outflow tract (the valve and artery that connect the heart with the lungs)
3.1.1.4. Overriding aorta (the artery that carries oxygen-rich blood to the body) that is shifted over the right ventricle and ventricular septal defect, instead of coming out only from the left ventricle
3.1.1.5. Thickened wall of the right ventricle (right ventricular hypertrophy)
3.2. Pathophysiology
3.2.1. Tetralogy of Fallot is rare, but it is the most common form of cyanotic congenital heart disease. People with tetralogy of Fallot are more likely to also have other congenital defects.
3.3. Effects & Symptoms
3.3.1. Blue color to the skin (cyanosis),which gets worse when the baby is upset Clubbing of fingers (skin or bone enlargement around the fingernails) Difficulty feeding (poor feeding habits) Failure to gain weight Passing out Poor development Squatting during episodes of cyanosis
3.4. Treatments
3.4.1. Surgery to repair tetralogy of Fallot is done when the infant is very young is done to help increase blood flow to the lungs.
3.4.2. Corrective surgery is done to widen part of the narrowed pulmonary tract and close the ventricular septal defect.
4. Atrioventricular Septal Defect
4.1. Pathophysiology
4.1.1. Also called Endocardial cushion defect (ECD). The walls separating all four chambers of the heart are poorly formed or absent.
4.2. Effects & Symptoms
4.2.1. The lack of separation between the two sides of the heart causes several problems:
4.2.2. Increased blood pressure in the lungs. In people with this condition, blood flows through the abnormal openings from the left to the right side of the heart, then to the lungs. More blood flow into the lungs makes the blood pressure in the lungs rise.
4.2.3. Irritation and swelling. This is caused by increased blood flow into the lungs.
4.2.4. Heart failure. The extra effort needed to pump makes the heart work harder than normal. The heart muscle may enlarge and weaken.
4.2.5. Cyanosis. As the blood pressure increases in the lungs, blood flow starts to move from the right side of the heart to the left. The oxygen-poor blood mixes with the oxygen-rich blood. As a result, blood with less oxygen than usual is pumped out to the body. This causes cyanosis, or bluish coloring of the skin.
4.3. Treatments
4.3.1. Surgery is needed to close the holes between the heart chambers, and to create distinct tricuspid and mitral valves. The timing of the surgery depends on the child's condition and the severity of the ECD. It can often be done when the baby is 3 - 6 months old. Correcting an ECD may require more than one surgery.
4.3.1.1. Drugs often used include: Diuretics (water pills) Drugs that make the heart contract more forcefully (inotropic agents), such as digoxin
5. Transposition of Great Arteries
5.1. Pathophysiology
5.1.1. The 2 major vessels that carry blood away from the heart -- the aorta and the pulmonary artery -- are switched (transposed).
5.2. Effects & Symptoms
5.2.1. Transposition of the great vessels is a cyanotic heart defect. This means there is decreased oxygen in the blood that is pumped from the heart to the rest of the body.
5.2.1.1. Symptoms appear at birth or very soon afterward. How bad the symptoms are depends on the type and size of additional heart defects (such as atrial septal defect, ventricular septal defect, or patent ductus arteriosus) and how much the blood can mix between the 2 abnormal circulations.
5.3. Treatments
5.3.1. The baby will immediately receive a medicine called prostaglandin through an IV (intravenous line). This medicine helps keep a blood vessel called the ductus arteriosus open, allowing some mixing of the 2 blood circulations.
5.3.1.1. A procedure using a long, thin flexible tube (balloon atrial septostomy) may be needed to create a large hole in the atrial septum to allow blood to mix.
5.3.1.1.1. A surgery called an arterial switch procedure is used to permanently correct the problem within the baby's first week of life. This surgery switches the great arteries back to the normal position and keeps the coronary arteries attached to the aorta.
6. Coarction of the Aorta
6.1. Pathophysiology
6.1.1. If part of the aorta is narrowed, it is hard for blood to pass through the artery. This is called coarctation of the aorta. It is a type of birth defect.
6.2. Effects & Symptoms
6.2.1. The exact cause of coarctation of the aorta is unknown. It results from abnormalities in development of the aorta prior to birth.
6.2.1.1. Aortic coarctation is more common in persons with certain genetic disorders, such as Turner syndrome.
6.2.1.1.1. Symptoms depend on how much blood can flow through the artery. Other heart defects may also play a role.
6.3. Treatments
6.3.1. During surgery, the narrowed part of the aorta will be removed or opened.
6.3.2. If the problem area is small, the two free ends of the aorta may be re-connected. This is called an end-to-end anastomosis.
6.3.3. If a large part of the aorta is removed, a graft or one of the patient's own arteries may be used to fill the gap. The graft may be man-made or from a cadaver.
7. Pulmonary Stenosis
7.1. Pathophysiology
7.1.1. Pulmonary valve stenosis is a heart valve disorder that involves the pulmonary valve. The valve separating the right ventricle and the pulmonary artery carries oxygen-poor blood to the lungs. Stenosis, or narrowing, occurs when the valve cannot open wide enough. As a result, less blood flows to the lungs.
8. Symptoms of CHD
8.1. Heart Murmurs
8.2. Acyanotic
8.3. Cyanotic
8.4. Heart Failure
9. Atrial Septal Defect
9.1. Pathophysiology
9.1.1. As a baby develops in the womb, a wall (septum) forms that divides the upper chamber into a left and right atrium.
9.2. Symptoms & Effects
9.2.1. Difficulty breathing (dyspnea) Frequent respiratory infections in children Feeling the heart beat (palpitations) in adults Shortness of breath with activity
9.3. Treatments
9.3.1. Surgery to close the defect if the defect causes a large amount of shunting& swollen heart.
10. Ventricular Septal Defect
10.1. Pathophysiology
10.1.1. Ventricular septal defect is a hole in the wall that separates the right & left ventricles of the heart.
10.2. Symptoms & Effects
10.2.1. Shortness of breath Fast breathing Hard breathing Paleness Failure to gain weight Fast heart rate Sweating while feeding Frequent respiratory infections
10.3. Treatments
10.3.1. Medicines may include digitalis (digoxin) and diuretics.
10.3.2. Surgery to close the hole
10.3.3. Special device during a cardiac catheterization
11. Patent Ductus Arteriosus
11.1. Ductus Arteriosus
11.1.1. Patent ductus arteriosus (PDA) is a condition in which the ductus arteriosus does not close.
11.1.1.1. PDA leads to abnormal blood flow between the 2 major blood vessels that carry blood from the heart to the lungs and to the rest of the body.
11.2. Disposing Factors
11.2.1. neonatal respiratory distress syndrome. Infants with genetic disorders, such as Down syndrome, or babies whose mothers had rubella during pregnancy are at higher risk for PDA.
11.2.1.1. hypoplastic left heart syndrome, transposition of the great vessels, and pulmonary stenosis.
11.3. Effects & Symptoms
11.3.1. Fast breathing Poor feeding habits Rapid pulse Shortness of breath Sweating while feeding Tiring very easily Poor growth
11.4. Treatments
11.4.1. medicines such as indomethacin or ibuprofen are often the first choice.
11.4.1.1. A transcatheter device closure is a procedure that uses a thin, hollow tube placed into a blood vessel.
11.4.1.1.1. Surgery involves making a small cut between the ribs to repair the PDA.
12. Aortic Stenosis
12.1. Pathophysiology
12.1.1. In aortic stenosis, the aortic valve does not open fully. This decreases blood flow from the heart.
12.2. Effects & Symptoms
12.2.1. As the aortic valve narrows, the left ventricle has to work harder to pump blood out through the valve. To do this extra work, the muscles in the ventricle walls become thicker. This can lead to chest pain.
12.2.1.1. Aortic stenosis mainly occurs due to the buildup of calcium deposits that narrow the valve. This is called calcific aortic stenosis.
12.2.1.1.1. Calcium buildup of the valve happens sooner in people who are born with abnormal aortic or bicuspid valves. In rare cases, calcium buildup can develop more quickly when a person has received chest radiation (such as for cancer treatment).
12.3. Treatments
12.3.1. Medicines are used to treat symptoms of heart failure or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, and beta-blockers.
12.3.1.1. Surgery to repair or replace the valve is often done for adults or children who develop symptoms.
12.3.1.1.1. A less invasive procedure called balloon valvuloplasty may be done instead of or before surgery.
12.3.1.1.2. A balloon is placed into an artery in the groin, threaded to the heart, placed across the valve, and inflated. However, narrowing often occurs again after this procedure.
12.3.1.1.3. A newer procedure done at the same time as valvuloplasty can implant an artificial valve. This procedure is most often done in patients who cannot have surgery, but it is becoming more common.