congenital/hereditary - left to right shunts

what is the most common congenital cardiac lesions

Left to Right Shunts

what is the most common in children

Left to Right Shunts

what are the 3 types of Left to Right Shunts

1. Atrial Septal Defect (Patent Foramen Ovale )

2. Ventricular Septal Defect

3. Patent Ductus Arteriosus

what is Left to Right Shunts

hole in the heart that makes blood go from left to right. it causes mixing of the blood

what is another name patent foramen ovale

atrial septal defect

what age is atrial septal defect

utero

where is atrial septal defect

two atria in utero

what is atrial septal defect

when the baby is born and the foramen ovale does not close creating a shunt

describe what is happening in atrial septal defect

blood from the left side goes to the right ventricle and atrium causing hypertrophy and increased pulmonary vascularity. overloading occurs and pool in the right ventricle

how can we best demonstrate atrial septal defect

echocardiography

which gender is atrial septal defect found in more

females

how do we detect atrial septal defect usually

heart murmur

what is the difference in heart murmur between ventricular and atrial septal defect?

ventricular, it is audible

which one is more severe, ventricular or atrial septal defect

ventricular

when do we expect heart failure for ventricular septal defect

6-8 weeks

why is ventricular septal defect more serious?

because the pressure in the ventricles are greater in the ventricles

symptoms of ventricular septal defect

increased pulmonary blood flow, hypertrophy of the left atrium and ventricle

why is there no huge hypertrophy in the right ventricle in ventricular septal defect

most of the blood is sent to the pulmonary vasculature

Tx for ventricular septal defect

surgery

modality for ventricular septal defect

ultrasound

what kind of overloading do we see in ventricular septal defect, diastolic or systolic

diastolic

what is the RA for ventricular septal defect

1. hypertrophy of the left atrium and ventricle

2. not much enlargement of the right atrium/ventricle

3. increased vasculature

4. enlarged pulmonary trunk

what is patent ductus arteriosus?

when the vessel does not close in utero. this happens when the baby is born prematurely and does not close on the first breathe thus leaking blood in to the aorta

symptoms of patent ductus arteriosus

• heart murmur

• cyanosis

what age group is affected by patent ductus arteriosus

80% of preemies under 28 weeks

RA for patent ductus arteriosus

left side hypertrophy and pulmonary vasculature

where does the blood go in patent ductus arteriosus

aorta > lungs > pulmonary vascular congestion > blood returning to the left atrium

modality for patent ductus arteriosus

echocardiography

Tx for patent ductus arteriosus

fluid restriction, diuretics, surgery when they are a atleast a year old

what can complicate left to right shunts

pulmonary hypertension