penyakit jantung pada anak
TRANSCRIPT
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PENYAKIT JANTUNG BAWAAN PADA ANAK
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Deteksi dini penyakit jantung pada anak
• Biru• Aktifitas kurang• Sesak• Batuk berulang• Berat badan tidak meningkat
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Structures of the heart
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Penyakit Jantung Bawaan• A. PJB Asianotik
– ASD– VSD– PDA
b. PJB Sianotik- TF- TGA
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Normal Heart
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Atrial Septal defect( ASD )
• Insidence : + 10 %• ♀: δ ratio = 2 : 1• Anatomy :
Defect on foramen ovale : Secundum ASD Defect at SVC and RA junction: sinus
venosus ASD Defect at ostium primum : primum ASD
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RA
RV
LA
LV
RA
RV
LA
LV
Atrial septal Defect
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Clinical findingsAsymptomaticAuscultation :
Normal 1st HS or loudWidely split and
fixed 2nd HSEjection systolic murmur
Atrial septal Defect
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Atrial Septal defect
ManagementSurgery : Preschool ageRecent treatment: transcatheter closure using
ASO (Amplatzer septal occluder)
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Ventricular septal defect• Insidence
20 % of all CHD No sex influence
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RA
RV
RA LALA
RV LVLV
Ventricular septal defect
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Ventricular Septal Defect
• Clinical findingsDay 1st after birth: murmur (-)After 2-6 weeks : murmur (+)Murmur : pansystolic grade 3/6 or higher
at LSB 3 Small muscular defect: early systolic murmurSignificant defect: Mid diastolic murmur at apex
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Ventricular septal defect
Management:
Definitive : VSD closure Surgery Transcatheter closure
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Patent Ductus Arteriosus Insidence
+ 10%Female : Male = 1.2 to 1.5 : 1Premature and LBW higher
AnatomyFetus: ductus arteriosus connects PA and aorta.
If ductus does not closs Patent Ductus arteriosus
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RA
RV
LA
LV
RA LA
RV LV
Patent Ductus Arteriosus
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Patent Ductus Arteriosus
• Clinical findings
Small defect: Symptom (-) Growth and development normal
Significant defect:Decreased exercise tolerantWeigh gained not goodFrequent URTI
Specific case: pulsus seler at 4th extremities
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Tetralogy FallotInsidence5-8% from all CHD
Sindroma consist of 4 items: VSD pulmonary stenosis aortic over-riding RVH
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Tetralogy Fallot
Hemodynamic acyanotic Hemodynamic cyanotic
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Tetralogy Fallot
• Diagnosis
Clinically : cyanosis Single 2nd HS, ejection systolic murmur
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CXR : Boot-shaped
Tetralogy Fallot
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Transposition of Great Artery
Insidence5% of CHD
AnatomyAbnormality of formation of trunkal septum that cause aorta arising from RV and PA arising from LV
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Transposition of Great artery
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Hemodynamic normal Hemodynamic of TGA“series” “parallel”
Transposition of Great artery
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TGA with large VSD TGA with VSD and PS
Transposition of Great artery
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• Clinical aspects
More frequent in maleBirth weight usually normal normal or biggerCyanotic vary from mild to severeAuscultation : single 2nd HS and loudMurmur vary from silent to pansystolic murmur or continuous murmur
Transposition of Great artery
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• DiagnosisClinically :
Suspicious if neonates presents with cyanotic with birth weight normal or bigger
Murmur (-)Single 2nd HS and loud
Transposition of Great artery
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Transposition of Great artery
CXR :CardiomegalyEgg-on-side
heart