临床医学先天性心脏病概论黄国英课件.pptVIP

Cardiovascular Diseases in Children（Conspectus ） HUANG Guoying（黄国英） Department of Pediatrics Fudan University Shanghai Medical School Children’s Hospital of Fudan University The Aim of This Class To understand the classification of CHD To know well the embryological development of heart, causes of CHD and its pathogenesis To know well the approaches of evaluation of CHD To know the characteristics of fetal circulation changes after birth To have a general idea about cardiovascular diseases in children, and the principle of treatment of CHD Children’s Hospital Cardiovascular Diseases in Children Congenital heart disease Viral myocarditis Rheumatic heart disease Cardiomyopathy Kawasaki Disease Arrhythmia Congestive heart failure Pericarditis Infective endocarditis Etc…. Embyological Development of Heart Formation of primitive heart tube Looping of primitive heart tube Formation of endocardial cushion Formation of interatrial septum Formation of interventricular septum Septation of aortic and pulmonary arteries Formation and Looping of Primitive Heart Tube Formation of Endocardial Cushion Formation of Endocardial Cushion Septation of Atria and Ventricles Septation of Atria Septation of Ventricles Septation of Great Arteries Evolvement of Arterial Arches Fetal Circulation  Changes after Birth Congenital Heart Diseases Definition： Cardiovascular malformations present during embryonic stages （胚胎期发生的心血管畸形） Prevalence： － 7~8 / 1000 newborns（reported data） － 6.87 / 1000 newborns in Shanghai （epidemiologic survey during 1989～1991） Etiologic Considerations Hereditary factors Trisomies of chromosome 21,18,13 CATCH22 syndrome （deletion of 22 q11 ) （22号染色体长臂q11区域微小缺失） Gene defects： －Mutations of Fibrillin in William’s syndrome －Defects of Elastin in Marfan’s syndrome －Mutations of Cx43 in Hypoplastic left heart Etiologic Considerations Environmental factors Exposed to the following factors during the first trimester of pregnancy －Viral infect