SCMC Pediatric and Congenital Heart Disease Common Problems asD VSD Pda and tof
Pediatric and Congenital Heart Disease Common Problems ASD, VSD,PDA and TOF
SCMC Heart Structure Heart is an complex spatial structure Differences in the pathophysiology of cardiac disease Pediatrics: congenital heart disease Adults: atherosclerotic heart disease
Heart Structure ⚫ Heart is an complex spatial structure ⚫ Differences in the pathophysiology of cardiac disease – Pediatrics: congenital heart disease – Adults: atherosclerotic heart disease
SCMC A word about diagnosis Clinical presentation--raising the suspicion ● Image is EVERyTh|NG Mainstay: echocardiography echo anatomy and hemodynamics Cardiac catheterization ImagIng hemodynamics ntervention
A word about diagnosis ⚫ Clinical presentation--raising the suspicion ⚫ Image is EVERYTHING ⚫ Mainstay: echocardiography – echo anatomy and hemodynamics ⚫ Cardiac catheterization – imaging – hemodynamics – intervention
SCMC Stages of Heart Formation 1. Early blood vessel formation 1)Intraembryonic blood vessel at 13 days 2)Extraembryonic blood vessels at 17 days 2. Development of heart 1) Position and cardiac tube at 22 days Heart beating at 26 days 2)Formation of heart loop at 22-24days 3Formation of ventricle 4)Development of sinus venosus 3. Formation of cardiac septa, valves, arterial system, systemic veins 2 weeks formation start 4 weeks circulation start 8 weeks four chamber heart
Stages of Heart Formation 1. Early blood vessel formation 1) Intraembryonic blood vessel at 13 days 2) Extraembryonic blood vessels at 17 days 2. Development of heart 1) Position and cardiac tube at 22 days Heart beating at 26 days. 2) Formation of heart loop at 22-24days 3) Formation of ventricle 4) Development of sinus venosus 3. Formation of cardiac septa, valves, arterial system, systemic veins 2 weeks formation start 4 weeks circulation start 8 weeks four chamber heart
SCMC Incidence of Congenital Heart Diseases 1. Lt to rt shunt (53%) 4. Obstructive Lesion (15% PDA 17% Coarctation 95% ASD 165% PS 2% VSD 13% MS etc 1.5% AVSD 3.5% Abn Pv return 3% LVOTO 1.3% 2. Rt to Lt Shunt(11 %) HLHS 09% TOF 4.5% AA 06% TA 3% 5. Valvular Lesion PA+VSD 25% Ebstein 1% PA+VS 05% AR 0.5% 3. Admixture Lesion (15 % MR 0.5% TGA SV aneurysm <0.5% Uniⅳ.Ht 6. Miscellaneous Atrial isomerism <2 DORV Arrhythmia 5% Truncus 0.8% Vascular ring 0.5% Corrected tGa 0.5%
Incidence of Congenital Heart Diseases 1. Lt to Rt Shunt ( 53 % ) PDA 17 % ASD 16.5 % VSD 13 % AVSD 3.5 % Abn. PV return 3 % 2. Rt to Lt Shunt (11 % ) TOF 4.5 % TA 3 % PA+VSD 2.5 % PA+IVS 0.5 % 3. Admixture Lesion ( 15 % ) TGA 5 % Univ. Ht. 5 % Atrial isomerism < 2 % DORV < 2 % Truncus 0.8 % Corrected TGA < 0.5 % 4. Obstructive Lesion ( 15 % ) Coarctation 9.5 % PS 2 % MS etc. 1.5 % LVOTO 1.3 % HLHS 0.9 % IAA 0.6 % 5. Valvular Lesion Ebstein < 1 % AR < 0.5 % MR < 0.5 % SV aneurysm < 0.5 % 6. Miscellaneous Arrhythmia 5 % Vascular ring 0.5 %