Group 4Dr Said Abd el-HadyBy: Syamil Safwan Ahmad Ashraf Izzul Fahmi Filla Dalila Syahidah

DEFINITION CAUSES HEART DEFECT CLASSIFICATION

Definition:ɷ Congenital heart disease, also called congenital

heart defect, includes a variety of malformations of the heart or its major blood vessels that are present at birth.

ɷ ‘Congenital’ means present at birth.

ɷ Congenital heart defects can be broadly categorised into two groups :

(1)Acyanotic heart defects: usually without cyanosis

(75% of all CHDs)(2)Cyanotic heart defects:

unoxygenated blood enters the systemic circulation Cyanosis (25% of all CHDs)

Causes:

Exposure of the pregnant mother to teratogenic agents during the sensitive period of organogenesis which extends throughout the 1st trimester

Teratogenic agents may be:

(1)Physical agents: X-rays or Gamma rays

(2)Chemical agents: Some drugs & hormones

(3)Mechanical agents: Pressure on the fetus

(4) Infectious agents: such as the virus of german measles & the bacteria of syphilis

Acyanotic Heart Defects

Ventricular Septal Defect (VSD)

Definition: It is a defect in the interventricular septum

Incidence: 2-3/1000 live births

The most common congenital heart anomaly (found in 30% of all newborns with a congenital heart anomaly)

Types: according to location of the defect:

Ventricular Septal Defect (VSD)Ventricular Septal Defect (VSD)

Incidence: 6.4/10,000 live births

The 2nd most common congenital heart anomaly

2:1 prevalence in female to male infants

Definition:Definition: It is a shunt between the 2 atria It is a shunt between the 2 atria which produces right but which produces right but NEVERNEVER left ventricular left ventricular hypertrophy.hypertrophy.

Minor cases may cause no symptoms and may Minor cases may cause no symptoms and may not require treatment not require treatment BUTBUT Larger defects may Larger defects may require surgical closure.require surgical closure.

Atrial Septal Defect (ASD)Atrial Septal Defect (ASD)

(1) Septum Secundum defect (90%): characterized by a large opening between the left & the right atria

(2) Septum primum defect(3) Sinus Venosus defect(4) Complete absence of Septum

Primum & Septum Secundum Trilocular heart. (rare)

Atrial Septal Defect (ASD)Atrial Septal Defect (ASD)

Types: according to location of the defect:

Atrioventricular septal defect (AVSD)

previously known as: common atrioventricular canal (CAVC) or endocardial cushion defect

The most common congenital heart anomaly that is associated with Down’s syndrome (Trisomy21)

Atrioventricular septal Atrioventricular septal defect (AVSD)defect (AVSD)

Cause:Cause: Complete failure of Complete failure of

fusion of the anterior & fusion of the anterior &

posterior endocardial posterior endocardial cushions cushions failure of failure of formation offormation of

septum intermediumseptum intermedium

Usually accompanied by Usually accompanied by ASDASD

& VSD (since the & VSD (since the endocardial Cushions share endocardial Cushions share in the formation of in the formation of interatrial & interventricular interatrial & interventricular Septa)Septa)

Patent ductus arteriosus (PDA)

Ω Before birth, a temporary blood vessel called the ductus arteriosus connects the pulmonary artery & the aorta.

Ω This allows blood to bypass the lungs (which are not functional yet) as O2 is delivered to the fetus through the placenta and umbilical cord.

Patent ductus arteriosus (PDA) Ductus arteriosus normally

closes within a few hours or days after birth as the lungs take over.

If it remains open (patent), some blood that should circulate through the body is misdirected to the lungs.

Pulmonary Stenosis Cause: Partial fusion of the

cusps of the pulmonary valve stenosis (narrowing) of the pulmonary valve opening.

The right ventricle must pump harder to get blood into the pulmonary artery thickening of the muscle of the right ventricle

Aortic Stenosis (AS) Cause: Partial fusion of the

cusps of the aortic valve This defect narrows the aortic

valve opening, making it difficult for the heart to pump blood into the aorta.

This defect can cause:heart enlargementLeft-sided heart failureArrhythmias Endocarditis

Coarctation of the aorta Definition: This is a

constriction in a portion of the aorta forces the heart to pump harder to get blood through the aorta and on to the rest of the body.

Incidence: 1-10,000 live births

More common with Turner’s syndrome (45,X0)

SUMMARY• Teratogenic agents are the main causes of

congenital heart disease.• The congenital heart disease are

classified into 2 main categories : Acyanotic & Cyanotic Heart Defects.

• There are different types of the congenital heart disease.

• It is very important to be diagnosed early to avoid long term health problem.

• ECG,chest x-ray, and echocardiograph can be used in the diagnosis of congenital heart anomalies.