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Congenital Heart Defects MODULE F Chapter Eleven Cardiac System Pages 348 - 359 Objectives Differentiate between the different congenital heart diseases and state whether they are cyanotic and acyanotic. Describe the defect present with each congenital heart disease. Describe the surgical repair (if any) for each congenital heart disease. Cardiac Defects Patent Ductus Arteriosus Atrial Septal Defect Ventricular Septal Defect Tetralogy of Fallot Transposition of the Great Arteries Coarctation of the Aorta Anomalous Venous Return Truncus Arteriosus Hypoplastic Left-Heart Syndrome Web Sites /educate/defects/defects.htm Normal Cardiac Blood Flow Ductus Arteriosus Fetal Circulation Component Connects Pulmonary Artery to Aorta Shunts blood away from lungs Maintained patent by presence of prostaglandins Closure secondary to: Increase in PaO2_ Decrease in level of prostaglandins Patent Ductus Arteriosus 5-10% of all births (1 of 2000 live births) 80% of premature babies 2-3 times more common in females than males. 5th or 6th most common congenital cardiac defect. Often associated with other defects. May be desirable with some defects. Morbidity/Mortality related to degree of blood flow through PDA. Pathophysiology - PDA With a drop in pulmonary arterial pressure (reduction in hypoxic pulmonary vascular constriction), blood will flow through PDA. LEFT TO RIGHT SHUNT Increased pulmonary blood flow may lead to pulmonary edema. Reduced blood flow to all postductal organs NEC If pulmonary artery pressure rises above Aortic pressure, blood will move in the other direction. RIGHT TO LEFT SHUNT Diagnosis - PDA Loud grade I to grade III systolic murmur at left sternal border. Washing machine Echocardiography Treatment - PDA Restrict fluids. Diuretics Prostaglandin Inhibitors - Indomethacin Surgical closure (ligation). Atrial Septal Defect 6-10% of all births (1 of 1500 live births) 2 times more common in females than males. Types: Ostium Secundum (at or about the Foramen Ovale) Si