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Acyanotic Congenital Heart Disease

Acyanotic Congen Heart Dis


Presentation

  • We present a case of an infant with critical aortic stenosis presenting with cyanosis, who was entirely dependent on ductal patency for systemic output.[ncbi.nlm.nih.gov]
  • The aim of the present study is to investigate the ghrelin in congenital heart disease and the association of ghrelin with TNF-alpha and IL-6. Materials and methods.[ncbi.nlm.nih.gov]
  • The present meta-analysis was conducted to investigate the clinical significance of serum levels of ghrelin and TNF-α in children with (CHD).[ncbi.nlm.nih.gov]
  • CONCLUSIONS: After treatment for aCHD, subtle cognitive difficulties can present in domains of visuospatial information processing, language, attention, and social perception.[ncbi.nlm.nih.gov]
  • Infants may be asymptomatic or present with exercise intolerance, failure to thrive, and symptoms of heart failure. Load Less Saumil R Shah, Sergio Waxman, William H Gaasch, et al US Cardiology Review 2017;11(2):72–4.[radcliffecardiology.com]
Plethora
  • […] otherwise often asymptomatic Exam: pink full volume pulses harsh systolic (1st few weeks) or continuous ‘machinery’ murmur loudest under left clavicle ECG: normal (small PDA) LVH RVH (large PDA) 17 18 PDA Options for closure: CXR: cardiomegaly, pulm plethora[slideplayer.com]
Overeating
  • Physical signs • Clinical findings (murmur) – Grade II-IV/VI, – medium- to high-pitched, – harsh – pansystolic murmur – heard best at the lower left sternal border with – radiation over the entire precordium 11.[slideshare.net]
  • (2–5/6) thrill at LUSB with radiation to back and sides Mild PS: Normal Moderate PS: RAD and RVH Severe PS: RAE and RVH with strain Normal heart size with normal to decreased PVMs Aortic stenosis (AS) Systolic thrill at RUSB, suprasternal notch, or over[unboundmedicine.com]
  • […] the pulmonary area Mid diastolic flow murmur over tricuspid area if significant shunt Mid diastolic flow murmur over mitral area if significant shunt Mid diastolic flow murmur over mitral area if significant shunt Step up in oxygen saturation at atrial[lifeinthefastlane.com]
  • Pregnant women who have diabetes should try to get good control over their blood sugar level. Certain genes may play a role in CHD. Many family members may be affected.[medlineplus.gov]
  • Rarely both subclavian may have a common origin from descending aorta 36 Manish Chandra Prabhakar Pulsations over back : Pulsations over back Pulsatile Dialated collaterals in coarctation Intercostal arteries over back Internal mammary artery anteriorly[authorstream.com]
Heart Disease
  • This study examined the relationship between congenital heart disease and oxidative stress in children with cyanotic and acyanotic congenital heart disease.[ncbi.nlm.nih.gov]
  • Increased energy expenditure is a primary factor in the reduced growth in infants with cyanotic congenital heart disease.[ncbi.nlm.nih.gov]
  • Implications of Rehabilitation Infants and toddlers with cyanotic congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease[ncbi.nlm.nih.gov]
  • Abstract This study was undertaken to screen children with congenital heart disease for coagulation abnormalities and to compare the groups of cyanotic and acyanotic children with congenital heart disease with respect to abnormalities of the coagulation[ncbi.nlm.nih.gov]
Systolic Murmur
  • murmur mid LSE and/or mid left back ECG: RVH in 1st few months of life, LVH if older 26 27 Coarctation of the Aorta CXR: cardiomegaly evidence of CHF rib notching (older child) Treatment: surgery for ‘native’ CoA balloon angioplasty for re-CoA[slideplayer.com]
  • murmur of MR at apex mid-diastolic rumble at LLSB or at apex gallop rhythm Superior QRS axis RVH and LVH may be present Cardiomegaly with increased PVMs Pulmonary stenosis (PS) Ejection click at LUSB with valvular PS—click intensity varies with respiration[unboundmedicine.com]
  • The child had a systolic murmur, grade 3/6, in the second and third left intercostal space, parasternally. The respiratory examination, abdominal examination, and central nervous system were normal.[jmgims.co.in]
  • BP 78/40, raised JVP. reduced ECG voltage, muffled heart sounds. mitral stenosis MS, is almost always due to what clinical presentation & examination of MS malar flush, fatigue, dyspnoea AF, tapping apex beat rumbling mid-diastolic murmur loud pan-systolic[cram.com]
Heart Murmur
  • Others are diagnosed at various ages subsequent to the detection of a heart murmur as part of routine screening or during clinical examination for intercurrent illness. Heart murmurs.[patient.info]
  • A heart murmur might be the only sign of PDA. (A heart murmur is an extra or unusual sound heard during a heartbeat.) Other signs and symptoms can include shortness of breath, poor feeding and growth, tiring easily, and sweating with exertion.[medicinenet.com]
  • While most heart murmurs in children are normal, some may be due to defects. If the heart problem is significant, your child’s pediatrician or family physician will likely refer your child to a pediatric cardiologist.[heart.org]
  • murmur Tachycardia Tachypnea Respiratory distress Mild cyanosis (in right sided heart failure) Poor growth and development (from increased energy spent on breathing) Complications [ edit ] This condition can cause congestive heart failure. [1] Diagnosis[en.wikipedia.org]
  • The vast majority of mothers will chose to continue with delivery Heart Murmurs The vast majority of children with a murmur have a harmless ‘innocent’ murmur! Innocent murmurs can be heard in 30% of children at some point.[almostadoctor.co.uk]
Narrow Pulse Pressure
  • pulse pressure if severe stenosis Mild AS: Normal Moderate – severe AS: LVH strain Usually normal Coarctation of aorta may present as: 1.[unboundmedicine.com]

Workup

Atelectasis
  • Children with acyanotic congenital heart disease frequently develop respiratory difficulties such as atelectasis, pneumonia, or infantile lobar emphysema.[ncbi.nlm.nih.gov]
Biventricular Hypertrophy
  • AR, Aortic regurgitation; ASD, atrial septal defect; BP, blood pressure; BVH, biventricular hypertrophy; CDG, congenital disorders of glycosylation; CHD, congenital heart disease; CHF, congestive heart failure; HTN, hypertension; LAE, left atrial enlargement[unboundmedicine.com]
  • . • Small VSD: – Chest X-ray & ECG - normal • Large VSD:  Chest X-ray • Cardiomegaly • Enlarged pulmonary arteries • Pulmonary vascular markings • Pulmonary oedema  ECG : Biventricular hypertrophy and signs of pulmonary HPT  right ventricular enlargement[slideshare.net]
Biventricular Hypertrophy
  • AR, Aortic regurgitation; ASD, atrial septal defect; BP, blood pressure; BVH, biventricular hypertrophy; CDG, congenital disorders of glycosylation; CHD, congenital heart disease; CHF, congestive heart failure; HTN, hypertension; LAE, left atrial enlargement[unboundmedicine.com]
  • . • Small VSD: – Chest X-ray & ECG - normal • Large VSD:  Chest X-ray • Cardiomegaly • Enlarged pulmonary arteries • Pulmonary vascular markings • Pulmonary oedema  ECG : Biventricular hypertrophy and signs of pulmonary HPT  right ventricular enlargement[slideshare.net]

Treatment

  • OBJECTIVE: The type of congenital heart disease, early diagnosis, and treatment modality all play an important role in the morbidity and mortality of these diseases.[ncbi.nlm.nih.gov]
  • […] and S2 systolic thrill harsh pansystolic murmur LLSE ECG: normal (smaller VSD) or LVH RVH (larger VSD) 8 VSD’s Larger defect: MDM @ apex (mitral flow murmur) narrowly split S2 and loud P2 S3 CXR: cardiomegaly increased pulmonary vascularity 9 VSD’s Treatment[slideplayer.com]
  • CONCLUSIONS: After treatment for aCHD, subtle cognitive difficulties can present in domains of visuospatial information processing, language, attention, and social perception.[ncbi.nlm.nih.gov]
  • Treatment surgery for native CoA balloon angioplasty for re-CoA[powershow.com]
  • Treatment:  Initial treatment (Medical) – diuretics and ACI (captopril) or digoxin diuretics for treatment of CHF.  Surgical repair of the entire defect ultimately is required. 26. Patent Ductus Arteriosus 27.[slideshare.net]

Prognosis

  • Nutritional conciderations in the prognosis treatment of children with congenital heart disease. In: Suskind RM, Levinter-Suskind L., editors. Textbook of Pediatric Nutrition.[pediatricsciences.com]
  • The prognosis is usually bad, and the patient dies within the first five years of life. What are Acyanotic Congenital Heart Defects? Acyanotic congenital heart defects are also due to the inborn structural defects in the circulatory system.[differencebetween.com]
  • Prognosis The prognosis for children with congenital heart disease has improved dramatically over the last few decades.[patient.info]
  • Prognosis & Complications • ASDs detected in term infants may close spontaneously.[slideshare.net]
  • Clinical Features, Complications, Prognosis And Treatment Of Mitral Regurgitation Disorder of mitral valve (MV) closure, either structural or functional, resulting in a backflow of part of the left ventricular (LV) stroke volume into the left atrium ([pinterest.es]

Etiology

  • Altered oxygen content of the blood owing to hypoxia in CCHD patients may be an important etiological factor in the genesis of bacteremia and cerebral abscess. The affection of immune functions in ACHD cannot be adequately explained.[ncbi.nlm.nih.gov]
  • Subclavian artery supply disruption sequence: Hypothesis of vascular etiology for Poland, Klippel Feil and Möbius anomalies. Am J Med Genet 1986;23:903-18. [ PUBMED ] 7. Caravella L, Rogers GL.[jmgims.co.in]
  • Causes: Most Common Etiologies Cyanotic Congenital Heart Disease (5 T's, with 1-5 mnemonic) Truncus Arteriosus (1 vessel) Transposition of the Great Vessels (2 vessels switched) Tricuspid valve atresia (3 valve cusps) Tetralogy of Fallot (4 components[fpnotebook.com]
  • Etiology, Pathogenesis, Diagnosis and Treatment of Selected Congenital Heart Diseases. Department of Cardiac Physiopathology, State University of Palermo Medical School. Palermo, Italy. February 1988 70.[sites.google.com]
  • Etiology of growth failure in children with CHD is multifactorial. Further studies are required to assess the role of different factors in this field.[scialert.net]

Epidemiology

  • Cardiac abnormalities are the largest group of congenital defects Epidemiology 8 per 1000 children have a significant congenital cardiac abnormality 1 in 10 still births have a cardiac abnormality 10-15% of cases have more than one abnormality 10-15%[almostadoctor.co.uk]
  • Epidemiology The reported total birth prevalence of congenital heart disease in Europe is 8.2 per thousand live births which is higher than reported birth prevalence in the USA (6.9 per thousand live births).[patient.info]
  • Epidemiologic, Clinical and Prognostic Features of Postoperative Blocks First International Conference on Arrhythmias in Infancy. Bari, Italy. June 1989 80. Exercise Testing in Pediatrics. Chicago Metropolitan Cardiology Technologists Association.[sites.google.com]
  • Epidemiology 1998;9:95-8. 24. Shi QY, Zhang JB, Mi YQ, Song Y, Ma J, Zhang YL. Congenital heart defects and maternal fever: Systematic review and meta-analysis. J Perinatol 2014;34:677-82. 25. Hasan I, Haleem AA, Bhutta ZA.[annalspc.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology • Higher aortic pressure, blood shunts left to right through the ductus • The magnitude of the excess pulmonary blood flow depends on: The internal diameter PDA.[slideshare.net]
  • Sometimes the blueishness only happens when they’re working really hard, like feeding and crying (or thinking about the pathophysiological mechanisms of heart disease).[sketchymedicine.com]
  • "Essentials of Pathophysiology: Concepts of Altered Health States" by Carol Porth says that congenital heart disease can be classified as cyanotic or acyanotic.[livestrong.com]
  • There are various results about the pathophysiology and the effect of cyanosis in children with CHD ( Da Silva et al ., 2007 ; Himeno, 2001 ; Himeno et al ., 2003 ).[scialert.net]

Prevention

  • Secundum ASDs • Prophylaxis for subacute bacterial endocarditis. • Surgical correction at 3-5 y/o to prevent right heart failure and arrhythmias in later life. Primum ASD 21.[slideshare.net]
  • The treatment of acyanotic CHD with currently available medical, transcatheter and surgical methods is feasible, safe and effective and should be performed at an appropriate age in order to prevent damage to cardiovascular structures.[link.springer.com]
  • Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.[healthline.com]
  • Prevention Although many forms of congenital heart disease are not currently preventable, the avoidance of known risk factors such as drugs and alcohol during pregnancy will help to reduce the risk.[patient.info]
  • Preventive Cardiology - Fraz A. Ismat and Richard M. Donner Index[libreriacortinamilano.it]

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