Week 1 Cardiac Alterations Classification of Congenital Heart disease

Patent Ductus Arteriosus (PDA)

Acyanotic congenital heart defect

left-to-right shunt.

Clinical manifestations: continuous machinery-type murmur, bounding pulses, active precordium, palpable thrill, and signs/symptoms of pulmonary overcirculation.

Atrial Septal Defect (ASD)

Acyanotic congenital heart defect

left-to-right shunt.

Clinical manifestations: often asymptomatic; may be detected by a heart murmur.

Ventricular Septal Defect (VSD)

Acyanotic congenital heart defect

left-to-right shunt.

Clinical manifestations: heart failure, poor weight gain, heart murmur, and systolic thrill.

Atrioventricular Canal Defect

Acyanotic congenital heart defect;

typically left-to-right shunting.

Clinical manifestations: murmur, heart failure, and respiratory tract infections.

Coarctation of the Aorta

Acyanotic obstructive congenital heart defect;

no primary shunt.

Clinical manifestations:

in newborns: heart failure, hypotension, acidosis, and shock after ductus closure. In

older children: upper-extremity hypertension, decreased or absent lower-extremity pulses, cool mottled skin, and leg cramps with exercise.

Aortic Stenosis

Acyanotic obstructive congenital heart defect;

no primary shunt.

Clinical manifestations: often asymptomatic, exercise intolerance, syncope, epigastric pain, exertional chest pain, and murmur.

Pulmonic Stenosis

Usually acyanotic obstructive congenital heart defect;

no primary shunt.

Clinical manifestations: often asymptomatic, exertional dyspnea, murmur, fatigue, thrill, cyanosis in severe disease, and heart failure.

Tetralogy of Fallot

Cyanotic congenital heart defect;

right-to-left shunt.

Clinical manifestations: cyanosis, hypoxia, clubbing, feeding difficulty, dyspnea, restlessness, squatting, and hypercyanotic or tet spells with crying or exertion.

Tricuspid Atresia

Cyanotic congenital heart defect;

right-to-left shunting is required for systemic circulation.

Clinical manifestations: central cyanosis, growth failure, exertional dyspnea, tachypnea, hypoxemia, polycythemia, clubbing, and hepatomegaly.

Transposition of the Great Arteries (TGA)

Cyanotic mixing congenital heart defect;

no simple left-to-right or right-to-left shunt because two parallel circulations are created.

Clinical manifestation: cyanosis that may be mild shortly after birth and worsen during the first day.

Total Anomalous Pulmonary Venous Connection (TAPVC)

Cyanotic mixing congenital heart defect;

mixed circulation rather than a simple left-to-right or right-to-left shunt.

Clinical manifestation: cyanosis.

Truncus Arteriosus

Cyanotic mixing congenital heart defect

mixed circulation rather than a simple left-to-right or right-to-left shunt.

Clinical manifestations: mild-to-moderate cyanosis that worsens with activity and a heart murmur.

Hypoplastic Left Heart Syndrome

Cyanotic/mixing congenital heart defect with severely reduced systemic blood flow;

not a simple left-to-right or right-to-left shunt.

Clinical manifestations: as the ductus closes, decreased systemic perfusion, hypoxemia, acidosis, shock, and a loud single second heart sound.