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    CHD Fetal Circulation

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    Nandita Chatterjee
    The document discusses the basics of congenital heart disease. It begins by describing fetal circulation and the changes that occur at birth. It then discusses the development of the normal heart and types of congenital heart defects including left-to-right shunts like atrial septal defects, ventricular septal defects, and patent ductus arteriosus. It also discusses right-sided outflow obstructions like pulmonary stenosis and Fallot's tetralogy, as well as mixing of blood in defects like transposition of the great arteries. Key signs and symptoms of different congenital heart defects are provided.

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    CHD Fetal Circulation

    Uploaded by

    Nandita Chatterjee
    23 views31 pages
    The document discusses the basics of congenital heart disease. It begins by describing fetal circulation and the changes that occur at birth. It then discusses the development of the normal heart and types of congenital heart defects including left-to-right shunts like atrial septal defects, ventricular septal defects, and patent ductus arteriosus. It also discusses right-sided outflow obstructions like pulmonary stenosis and Fallot's tetralogy, as well as mixing of blood in defects like transposition of the great arteries. Key signs and symptoms of different congenital heart defects are provided.

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    The document discusses the basics of congenital heart disease. It begins by describing fetal circulation and the changes that occur at birth. It then discusses the development of the normal heart and types of congenital heart defects including left-to-right shunts like atrial septal defects, ventricular septal defects, and patent ductus arteriosus. It also discusses right-sided outflow obstructions like pulmonary stenosis and Fallot's tetralogy, as well as mixing of blood in defects like transposition of the great arteries. Key signs and symptoms of different congenital heart defects are provided.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    23 views31 pages

    CHD Fetal Circulation

    Uploaded by

    Nandita Chatterjee
    The document discusses the basics of congenital heart disease. It begins by describing fetal circulation and the changes that occur at birth. It then discusses the development of the normal heart and types of congenital heart defects including left-to-right shunts like atrial septal defects, ventricular septal defects, and patent ductus arteriosus. It also discusses right-sided outflow obstructions like pulmonary stenosis and Fallot's tetralogy, as well as mixing of blood in defects like transposition of the great arteries. Key signs and symptoms of different congenital heart defects are provided.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 31

    BASICS OF CONGENITAL

    HEART DISEASE
    Fetal Circulation
    Pre-condition
     Oxygenated blood from placenta

     Lungs ineffective

     Rt heart has little role

    Characteristic of Fetal Circulation


     Oxygenated blood flows through systemic venous

    system rt heartleft heart systemic circulation


     Rt heart outflow insignificant

     Rt heart outflow re-directed to systemic circulation


    Changes at birth
     Pulmonary vascular resistance decreases
     Systemic vascular resistance increases
     Ductus venosus closes
     ASD closes
     Ductus arteriosus closes
    Development of heart
    Primitive heart
    tube
    Atrial Septum
    NORMAL HEART
    Congenital Heart Disease
     Left/ Rt mixing through a
    hole/communication
     Outflow obstruction: atriaventricles
    Ventricles great vessels

     Atrio-ventricular mixing through a communication:


    defect in valves
    CLASSIFICATION

    SHUNTS
     L R VSD, ASD, PDA
     R L EISSENMENGER,
    TOF
    OBSTRUCTION
     Rt sided outflow obstrn: PS , PA
     Lt sided outflow obstrn :
    AS, Coarctation

    MIXING OF BLOOD DORV, TGA, SV, TAPVC,


    Persistent Truncus
    Congenital Heart Diseases
    L R SHUNTS
     Recurrent RTI
     Large heart
     Pre cordial bulge
     Hyperkinetic heart
     Co-exiting TR/ MR
     Plethoric lung fields
    RL SHUNT
     Cyanosis
     With increased pulmonary blood flow
     Pulmonary Arterial Hypertension
     Cardiomegaly
     CCF
     Plethora
     With pulmonary outflow obstruction: see Fallot’s
    Physiology
    MIXING OF BLOOD
     Cyanosis
     Recurrent RTI
     Large heart
     Pre cordial bulge
     Hyperkinetic heart
    OUTFLOW TRACT OBSTRUCTION

     No bulge, no heave, silent heart


     Concentric hypertrophy, later failure
     Rt side obstruction: cyanosis
     Lt side obstruction: dyspnea, fatigue, syncope,
    pain
    LeftRt Shunt
     Atrial Septal defect
     Ventricular Septal defect
     Patent Ductus Arteriosus
    Atrial Septal Defect

     Most common form of ASD


    (fossa ovalis)
     In large defects, a
    considerable shunt of
    oxygenated blood flows
    from the left to the right
    atrium.
     Mostly asymptomatic
     The 2nd heart sound is
    characteristically widely
    split and fixed. Secundum
    Atrial Septal defect

     LtRt shunt at atrial level


     Rt atrium dilates to accommodate extra blood
     Rt ventricle enlarges
     Large volume blood thru normal tricuspid valve:
    delayed diastolic murmur
     Large volume blood thru normal pulm valve:
    Ejection systolic murmur
     P2 fixed wide split
    Ventricular Septal defect

     Flow of blood from LtRt ventricle from early


    systole, continues thru’ out systole. Even after
    aortic valve closes (A2) : Pan systolic murmur
     This extra blood passes on into pulmonary artery
    during systole. So no Rt ventricular dilatation.
     Pulmonary circulation overloaded Venous return
    to Lt Atrium: overload Left Atrial enlargement:
    delayed diastolic murmur
     Left ventricular overload LVH
    Patent Ductus Arteriosus

     Lt Rt shunt from aorta to pulmonary artery


     Continues through out systole and diastole:
    machinery systolo-diastolic murmur
     Left atrial enlargement and LVF
    Rt sided Outflow Obstruction
     Pulmonary Stenosis/ Atresia
    (Pre-valvar/valvar/post valvar)

     Fallot’s Physiology
     Pulmonary outflow obstruction
     Rt Ventricular pressure increased
     RtLt shunt
    Fallot’s Physiology

    Presentation
     Cyanosis

     Normal sized heart/ RVH

     Ejection systolic murmur

    Conditions:
     Fallot’s Tetralogy
     TGA with VSD-PS
     Corrected TGA with VSD-PS
     DORV with VSD-PS
     Single Ventricle with PS
     Tricuspid atresia with diminished pulmonary flow
    Tetralogy of Fallot
    Normal vs Fallots
    Fallots Physiology

    TOF Single
    Ventricle,
    PS

    DORV
    TGA
    Acyanotic CHD

    Normal ASD VSD

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