- 8/1000 live births
Acyanotic
Ventricular septal defect
-
incidence 20%
-
large range
- fulminant heart failure -> asymptomatic
-
pansystolic murmur (thrill)
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features of heart failure
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pulomnary htn if large
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sternal heave
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increase p2
-
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may decrease in size or close spont
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treat if large/symptomatic
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heart fialure
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ftt
-
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surgical repair
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increase risk of endocarditis
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Eisenmenger’s syndrome
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L -> R shunt
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increase pulm blood flow - pulm. HTN
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pulm pressures > systemic
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reversal of shunt R -> L
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cyansois
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may occur with untreated BSD/PDA or ASD (rarely)
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decrease QOL - cyanosis
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die prematurely
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arrhythmia and sudden cardiac death
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bleeding and clotting issues
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increase risk of systemic emboli
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haemoptysis
- pulmonary infarct/haemorrhoage
-
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Heart/lung transplant
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Atrial septal defect
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10-15%
-
F>M
-
Types
-
secundum (commonest)
-
primum ASD (AVSD)
- common Trisomy 21
-
sinus venosus (near SVC juntion)
-
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largely asymptomatic in childhood
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symptoms often 4th decade and beyond
-
heart failure
-
atrial arrhythmia
-
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signs
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RV overload
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ESM in pulmonary region
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fixed splitting S2
-
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needs closure
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usually by 5
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AVSD in infancy
-
surgical/percutaneous
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Patent ductus arteriosus
Pulmonary stenosis
Coarctation of aorta
-
variety of presentations
-
heart failure
-
htn inc hild/young adult
-
asymptomatic murmur
-
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signs
-
decrease femoral pulses
-
radiofemoral delay
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upperlimb htn
-
systolic murmur hears ant + post
- continuosu if severe
-
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investigations
-
ECG - LVH
-
CXR
-
rib notching
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due to collaterals (>5yo)
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abnormal aortic arch contur (3 sign)
-
-
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Aortic stenosis
Cyanotic
Tetralogy of Fallot
-
features
-
VSD
-
right ventricular outlet obstruction/pulmonary stenosis
-
overriding aorta
-
right ventricular hypertrophy
-
-
primary repair before later repair
Transposition of great arteries
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ventriculo-arterial discordance
-
parallel circulation
-
invompatible with life unless mixing
-
PDA
- deterioration when this closes
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ASD
- congenital or acquired
-
VSD
- complex
-