Download - Congenital Anomalies of the heart
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CONGENITAL ANOMALIES OF
THE HEARTDR RANIA GABR
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OBJECTIVES Discuss the congenital anomalies related to the
heart development.
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Congenital Heart Defect
Acyanotic Cyanotic
volume load pressure load ↑ pulmonary flow ↓ pulmonary flow
left-to-right shunts obstr. ventric. outflow
• atrial septal defect • pulmonary valve stenosis transpos. of gr. Vessels tetralogy of Fallot
• ventricular septal defect aortic valve stenosis single ventricle pulmonary atresia
• AV canal coarctation of aorta truncus arteriosus tricuspid atresia
• patent ductus arteriosus total anomalous pulm. total anomalous pulm.
return w/o obstruction return w/ obstruction
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Atrial Septal defects:
Septum Primum Defect:Defect in the interatrial septumDue to absence of the septum Primum (Patent foramen ovale)
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Septum Secondum Defect:Defect in the interatrial septumDue to absence of the septum Secondum (Patent foramenSecondum)
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Complete absence of the interatrial septum (Core Triloculare Biventriculare):
There is complete absence of both septum primum and septum secondum. i.e. there is a common atrium.
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Patent osteum primum:
The foramen primum may fail to close inspite of formation of the foramen secondum .
This will cause disturbance in the valvular mechanism of the interatrial septum.
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Patent foramen ovale: Mentioned before
Premature closure of foramen ovale:Rarely , it is closed BEFORE birth.It results in marked enlargement of the Right atrium and ventricle.
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Persistent atrioventricular canal:
The A-V cusions and the septum intermedium fail to develop.
The A-V canal remains divided into rt and lt parts.
There is usually: 1- Patent foramen primum 2- IV sepltal defect 3- Abnormalities in the
leaflets of the valves guarding the A-V canal.
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Ventricular Septal defects:
Usually in the membranous part
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Tetralogy of Fallot:
Four co-occurring heart defects:
• Pulmonary stenosis
• Ventricular septal defect
• Overriding aorta (dextroposition)
• Right ventricular hypertrophy
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Eisenmenger's syndrome:
Characteristics of Eisenmenger's syndrome summarized as:
• persistent truncus arteriosus
• ventricular septal defect • left-right ventricular
shunt • right ventricle
hypertrophy
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Congenital Aortic valve stenosis:
Occurs due to fusion of the cusps of the aortic valve .
Very narrow aortic orifice will cause Lt ventricular hypertrophy.
Regurge of blood from the aorta to the left ventricle will increase the lt ventr. Hypertrophy.
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Congenital Aortic valve atresia:
Under developed lt ventricle
Narrow ascending aorta Patent ductus arteriosus
to carry the blood into the aorta
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Pulmonary atresia The pulmonary artery is
underdeveloped, the right ventricle very small, and also sometimes the tricuspid valve. The condition is also sometimes referred to as hypoplastic right heart.
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Transposition of the great arteries:
Most common cyanotic neonatal heart defect
• Failure of aorticopulmonary septum totake a spiraling course• Fatal without PDA, ASD, & VSD
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Single ventricle:A univentricular heart may be best described as a defect that encompasses two complete atria that provide venous inflow into a dominant ventricle (either right or left) via a malformed AV connection.
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Ectopia Cordis:
The heart is bulging outside the chest due to wide separation in the 2 parts of the sternum
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Dextrocardia: The heart and great
vessels are reversed as in mirror image
It might be a separate condition or part of Situs inversus
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Situs inversus
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