发绀型先天性心脏病.pptVIP

Clinical Signs for Unobstructed Veins Mild cyanosis, signs of CHF in infancy, history of pneumonia Widely split S2, Grade 2-3/6 systolic murmur heard at the ULSB CXR- marked cardiomegaly Clinical Signs for Obstructed Veins Profound desaturation Acidosis PGE1 administration does not improve oxygenation because elevated pulmonary pressures in the right side of the heart (due to obstructed pulmonary outflow) will result in right to left shunting across an open ductus further decreasing arterial saturation. Treatment Digitalis and diuretics to treat heart failure Intubation and inc PEEP for those with severe pulm over load Corrective surgery Tricuspid Atresia Tricuspid valve is absent RV and PA are hypoplastic Associated defects- ASD, VSD, or PDA (necessary for survival) Dilation of LA and LV Essentially single ventricle physiology Clinical Signs Severe cyanosis, poor feeding, tachypnea Single S2, grade 3/6 systolic murmur at LLSB if VSD is present CXR- boot shaped heart Treatment PGE IV infusion Blalock-Taussig shunt in infancy systemic to pulmonary arterial shunt Provide stable blood flow to the lungs A gortex tube is sewen between the subclavian artery and the right pulmonary artery Bidirectional Glenn Superior vena cava is connected to the pulmonary arteries IVC continues to be connected to the heart Fontan Procedure Redirects IVC to lungs Truncus Arteriosus A single trunk leaves the heart Gives rise to pulm, systemic, and coronary circulations Large VSD is always present Clinical Signs Cyanosis immediately after birth Early signs of CHF 2-4/6 systolic murmur at LSB suggestive of VSD Treatment Anticongestive medications (diuretics and digitalis) Corrective surgery VSD is closed Pulmonary artery is separated from the truncus Continuity is then established between the right ventricle and the pulmonary artery utilizing a valved homograft conduit Case presentation (pink kid turns blue, blue ki)d comes out What would you think about Where does cyanotic heart dis