logging in or signing up Congenital Heart Disease samarsen Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINTLite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 1312 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: November 02, 2009 This Presentation is Public Favorites: 3 Presentation Description Case presentations highlighting common congenital heart problems Comments Posting comment... By: drmanglasood (4 month(s) ago) a very good presentation.pls allow me to download at drmanglasood@gmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: pwn12 (10 month(s) ago) nice presentation. Plz send this ppt on my email- pwn012@yahoo.com Saving..... Post Reply Close Saving..... Edit Comment Close By: kumarpre (12 month(s) ago) can you email slides to kumarpre@hotmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: kingman121211 (17 month(s) ago) fantastic Saving..... Post Reply Close Saving..... Edit Comment Close By: austinisaac (19 month(s) ago) this was helpfull Saving..... Post Reply Close Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript CONGENITAL HEART DISEASE : CONGENITAL HEART DISEASE Dr S Sen Specialist Registrar Paediatrics North Western Deanery INCIDENCE : INCIDENCE CONGENITAL HEART DISEASE -8/1000 births CYANOTIC HEART DISEASE - 1/3rd of above CASE HISTORY 1 : CASE HISTORY 1 10 day old ,male infant presents to A & E dept. H/O off feeds x 2 days Lethargic Pale : Pallor, dyspnoeic , grunting Irritable , weak cry, poor pulses RR 60/min , Liver 3 cm. 2/6 Pan Systolic murmur Left lower sternal border Bilateral basal crepitations. CASE HISTORY 1 OTHER SIGNS / SYMPTOMS : OTHER SIGNS / SYMPTOMS Tachycardia Gallop rhythm Sweating Wt. Loss DD : DD Coarctation of aorta Severe Aortic Stenosis Interrupted Aortic Arch Hypoplastic Left Heart Myocarditis / Cardiomyopathy SVT A-V fistula : Vein of Galen Anaemia MANAGEMENT : MANAGEMENT Airways , Oxygenation ! Volume / Diuretics Correct acidosis Blood sugar / Calcium / Potassium Sepsis / anaemia Prostaglandin Inotropes COARCTATION OF AORTA : COARCTATION OF AORTA Balloon angioplasty End to end repair Subclavian flap repair Stent CASE HISTORY 2 : CASE HISTORY 2 10 Yrs , male Asymptomatic Incidental murmur 2 yrs. Age O/E : HS normal , click 2nd. 3/6 ESM URSE, Carotid radiation Slide 11: AORTIC STENOSIS Valvar Supra-valvar Sub-valvar Balloon dilatation Surgery-valvotomy replacement - mechanical / Autograft resection CASE 3 : CASE 3 5 day old baby Respiratory distress 3/6 systolic murmur Normal saturations Enlarged heart on Chest X Ray Slide 13: HYPOPLASTIC LEFT HEART SYNDROME Under development of L heart structures Mitral Valve / LV / Aorta Duct dependant Norwood’s procedure Stage 1 & 2 Fontan’s Heart transplant Slide 15: NORWOOD’S STAGE 1 Within 2 wks. Mortality 30% Accept Sats. 70-85 in air Oxygen only with greatest caution Treat resp. infections promptly Very low threshold for hospitalization Slide 16: CYANOTIC HEART DISEASE CASE HISTORY 3 : 2 Yrs. Old, Asian female Cyanosis noted 2 wks. Age Asymptomatic , feeding well O/E : 1st.HS –N, 2nd.HS – single 4/6 ESM ULSE, 3/6 CM bilat. Infraclavicular CASE HISTORY 3 Slide 18: CENTRAL CYANOSIS Generalised Blueness Occurs in 30% of congenital heart disease patients TGA Complete AVSD DIAGNOSIS : DIAGNOSIS Cyanosis Tachycardia Tachypnoea Acidosis Poor capillary refill time Hyopotension DIFFERENTIAL DIAGNOSIS : DIFFERENTIAL DIAGNOSIS Respiratory Distress Syndrome Persistent Foetal Circulation Methaemoglobinaemia PERSISTENT FOETAL CIRCULATION : PERSISTENT FOETAL CIRCULATION Causes: Meconium aspiration Asphyxia Polycythaemia Maternal drugs- Aspirin,Indomethacin etc Hypoplastic lung PERSISTENT FOETAL CIRCULATION : PERSISTENT FOETAL CIRCULATION Marked cyanosis Respiratory distress B.P. normal Loud pansystolic murmur CXR Echocardiography CYANOTIC CONGENITAL HEART DISEASE : CYANOTIC CONGENITAL HEART DISEASE Fallot’s Tetralogy Transposition of Great arteries Tricuspid Atresia Aortic/Mitral Atresia Total anomalous Pulmonary Venous drainage Pulmonary Atresia / intact septum Double outlet right ventricle Single Ventricle Anomalous systemic venous drainage Pulmonary Arterio-venous aneurysms MURMURS : MURMURS Systolic Diastolic Fallot’s tetralogy Truncus arteriosus Tricuspid atresia Pulmonary atresia None Truncus arteriosus TGA DORV Ao /Mi. atresia TAPVD TAPVD Single ventricle CHEST X-RAY ( Heart Size ) : CHEST X-RAY ( Heart Size ) Large TGA Tricuspid Atresia Ao/Mi. Atresia Single Ventricle Truncus Atreriosus Ebstein’s Anomaly Lt. -> Rt. Shunts Small Fallot’s tetralogy TAPVD-Infradiaphragmatic Normal TGA Pulmonary Atresia CHEST X-RAY (LUNGS) : CHEST X-RAY (LUNGS) Oligaemic Plethoric Fallot’s Tetralogy Truncus Arteriosus Pulmonary Atresia TGA Tricuspid Atresia TAPVD Single ventricle Left -> Right Shunts Fallot’s Tetralogy : Fallot’s Tetralogy Start Prostaglandin E1 5 Nanograms/Kg/min. Correct Acidosis Accept Sats. 75-85 in air Treat infection Maintain adequate hydration Hypercyanotic spell: IV Propranolol/ morphine oxygen / phenylephrine FALLOT’S TETRALOGY : FALLOT’S TETRALOGY Balloon Pulmonary valvuloplasty Blalock Taussig shunt Correction Slide 34: TRANSPOSITION OF GREAT ARTERIES Slide 35: TGA Prostaglandin E1 Balloon atrial septostomy Arterial switch Atrial switch - Mustard’s / Senning’s Complex TGA - Fontan’s Slide 36: PULMONARY HYPERTENSION Primary / Secondary Reversible or not ? Cardiac catheterisation / Lung biopsy Active treatment of infections / immunisation hydration / diet Oxygen / Prostacyclin / Sildenafil Heart - lung transplant Slide 37: ACQUIRED HEART DISEASE Myocarditis Rheumatic heart disease Kawasaki’s disease Endocarditis Slide 38: INFECTIVE ENDOCARDITIS Symptoms Signs Investigations Treatment - 2 Antibiotics I.V. x 6 wks. Repair lesion Prevention Slide 39: KAWASAKI’S DISEASE Mortality related to cardiac involvement Myocarditis / Pericarditis / Effusion Prox. Coronary dilatation Infarction Late coronary stenosis / thrombus / infarct. Immunoglobulin / Aspirin Slide 40: COMMON CARDIAC SYNDROMES Down’s syndr.: AVSD / ASD / VSD / Fallot’s Turner’s : Coarct. Of Ao./ Ao. St. DiGeorge / VCF : Truncus / TGA / Fallot’s / VSD William’s : Supra valvar AS / PS / Coarct. Noonan’s : PS / Cardiomyopathy Alagille’s : peripheral PS Slide 41: FOETAL CARDIAC TERATOGENS Alcohol : ASD / VSD / TGA Phenytoin : AS / PS / Coarct. / PDA Valproate : Fallot’s / VSD Lithium : Ebstein’s Warfarin : Foetal loss Viruses : Rubella / CMV Slide 42: MATERNAL RISK FACTORS Diabetes : HCM / VSD / Coarct. SLE : Congenital complete heart block Phenylketonuria : Fallot’s THANK YOU : THANK YOU You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Congenital Heart Disease samarsen Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINTLite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 1312 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: November 02, 2009 This Presentation is Public Favorites: 3 Presentation Description Case presentations highlighting common congenital heart problems Comments Posting comment... By: drmanglasood (4 month(s) ago) a very good presentation.pls allow me to download at drmanglasood@gmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: pwn12 (10 month(s) ago) nice presentation. Plz send this ppt on my email- pwn012@yahoo.com Saving..... Post Reply Close Saving..... Edit Comment Close By: kumarpre (12 month(s) ago) can you email slides to kumarpre@hotmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: kingman121211 (17 month(s) ago) fantastic Saving..... Post Reply Close Saving..... Edit Comment Close By: austinisaac (19 month(s) ago) this was helpfull Saving..... Post Reply Close Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript CONGENITAL HEART DISEASE : CONGENITAL HEART DISEASE Dr S Sen Specialist Registrar Paediatrics North Western Deanery INCIDENCE : INCIDENCE CONGENITAL HEART DISEASE -8/1000 births CYANOTIC HEART DISEASE - 1/3rd of above CASE HISTORY 1 : CASE HISTORY 1 10 day old ,male infant presents to A & E dept. H/O off feeds x 2 days Lethargic Pale : Pallor, dyspnoeic , grunting Irritable , weak cry, poor pulses RR 60/min , Liver 3 cm. 2/6 Pan Systolic murmur Left lower sternal border Bilateral basal crepitations. CASE HISTORY 1 OTHER SIGNS / SYMPTOMS : OTHER SIGNS / SYMPTOMS Tachycardia Gallop rhythm Sweating Wt. Loss DD : DD Coarctation of aorta Severe Aortic Stenosis Interrupted Aortic Arch Hypoplastic Left Heart Myocarditis / Cardiomyopathy SVT A-V fistula : Vein of Galen Anaemia MANAGEMENT : MANAGEMENT Airways , Oxygenation ! Volume / Diuretics Correct acidosis Blood sugar / Calcium / Potassium Sepsis / anaemia Prostaglandin Inotropes COARCTATION OF AORTA : COARCTATION OF AORTA Balloon angioplasty End to end repair Subclavian flap repair Stent CASE HISTORY 2 : CASE HISTORY 2 10 Yrs , male Asymptomatic Incidental murmur 2 yrs. Age O/E : HS normal , click 2nd. 3/6 ESM URSE, Carotid radiation Slide 11: AORTIC STENOSIS Valvar Supra-valvar Sub-valvar Balloon dilatation Surgery-valvotomy replacement - mechanical / Autograft resection CASE 3 : CASE 3 5 day old baby Respiratory distress 3/6 systolic murmur Normal saturations Enlarged heart on Chest X Ray Slide 13: HYPOPLASTIC LEFT HEART SYNDROME Under development of L heart structures Mitral Valve / LV / Aorta Duct dependant Norwood’s procedure Stage 1 & 2 Fontan’s Heart transplant Slide 15: NORWOOD’S STAGE 1 Within 2 wks. Mortality 30% Accept Sats. 70-85 in air Oxygen only with greatest caution Treat resp. infections promptly Very low threshold for hospitalization Slide 16: CYANOTIC HEART DISEASE CASE HISTORY 3 : 2 Yrs. Old, Asian female Cyanosis noted 2 wks. Age Asymptomatic , feeding well O/E : 1st.HS –N, 2nd.HS – single 4/6 ESM ULSE, 3/6 CM bilat. Infraclavicular CASE HISTORY 3 Slide 18: CENTRAL CYANOSIS Generalised Blueness Occurs in 30% of congenital heart disease patients TGA Complete AVSD DIAGNOSIS : DIAGNOSIS Cyanosis Tachycardia Tachypnoea Acidosis Poor capillary refill time Hyopotension DIFFERENTIAL DIAGNOSIS : DIFFERENTIAL DIAGNOSIS Respiratory Distress Syndrome Persistent Foetal Circulation Methaemoglobinaemia PERSISTENT FOETAL CIRCULATION : PERSISTENT FOETAL CIRCULATION Causes: Meconium aspiration Asphyxia Polycythaemia Maternal drugs- Aspirin,Indomethacin etc Hypoplastic lung PERSISTENT FOETAL CIRCULATION : PERSISTENT FOETAL CIRCULATION Marked cyanosis Respiratory distress B.P. normal Loud pansystolic murmur CXR Echocardiography CYANOTIC CONGENITAL HEART DISEASE : CYANOTIC CONGENITAL HEART DISEASE Fallot’s Tetralogy Transposition of Great arteries Tricuspid Atresia Aortic/Mitral Atresia Total anomalous Pulmonary Venous drainage Pulmonary Atresia / intact septum Double outlet right ventricle Single Ventricle Anomalous systemic venous drainage Pulmonary Arterio-venous aneurysms MURMURS : MURMURS Systolic Diastolic Fallot’s tetralogy Truncus arteriosus Tricuspid atresia Pulmonary atresia None Truncus arteriosus TGA DORV Ao /Mi. atresia TAPVD TAPVD Single ventricle CHEST X-RAY ( Heart Size ) : CHEST X-RAY ( Heart Size ) Large TGA Tricuspid Atresia Ao/Mi. Atresia Single Ventricle Truncus Atreriosus Ebstein’s Anomaly Lt. -> Rt. Shunts Small Fallot’s tetralogy TAPVD-Infradiaphragmatic Normal TGA Pulmonary Atresia CHEST X-RAY (LUNGS) : CHEST X-RAY (LUNGS) Oligaemic Plethoric Fallot’s Tetralogy Truncus Arteriosus Pulmonary Atresia TGA Tricuspid Atresia TAPVD Single ventricle Left -> Right Shunts Fallot’s Tetralogy : Fallot’s Tetralogy Start Prostaglandin E1 5 Nanograms/Kg/min. Correct Acidosis Accept Sats. 75-85 in air Treat infection Maintain adequate hydration Hypercyanotic spell: IV Propranolol/ morphine oxygen / phenylephrine FALLOT’S TETRALOGY : FALLOT’S TETRALOGY Balloon Pulmonary valvuloplasty Blalock Taussig shunt Correction Slide 34: TRANSPOSITION OF GREAT ARTERIES Slide 35: TGA Prostaglandin E1 Balloon atrial septostomy Arterial switch Atrial switch - Mustard’s / Senning’s Complex TGA - Fontan’s Slide 36: PULMONARY HYPERTENSION Primary / Secondary Reversible or not ? Cardiac catheterisation / Lung biopsy Active treatment of infections / immunisation hydration / diet Oxygen / Prostacyclin / Sildenafil Heart - lung transplant Slide 37: ACQUIRED HEART DISEASE Myocarditis Rheumatic heart disease Kawasaki’s disease Endocarditis Slide 38: INFECTIVE ENDOCARDITIS Symptoms Signs Investigations Treatment - 2 Antibiotics I.V. x 6 wks. Repair lesion Prevention Slide 39: KAWASAKI’S DISEASE Mortality related to cardiac involvement Myocarditis / Pericarditis / Effusion Prox. Coronary dilatation Infarction Late coronary stenosis / thrombus / infarct. Immunoglobulin / Aspirin Slide 40: COMMON CARDIAC SYNDROMES Down’s syndr.: AVSD / ASD / VSD / Fallot’s Turner’s : Coarct. Of Ao./ Ao. St. DiGeorge / VCF : Truncus / TGA / Fallot’s / VSD William’s : Supra valvar AS / PS / Coarct. Noonan’s : PS / Cardiomyopathy Alagille’s : peripheral PS Slide 41: FOETAL CARDIAC TERATOGENS Alcohol : ASD / VSD / TGA Phenytoin : AS / PS / Coarct. / PDA Valproate : Fallot’s / VSD Lithium : Ebstein’s Warfarin : Foetal loss Viruses : Rubella / CMV Slide 42: MATERNAL RISK FACTORS Diabetes : HCM / VSD / Coarct. SLE : Congenital complete heart block Phenylketonuria : Fallot’s THANK YOU : THANK YOU