What Are the Main Acyanotic Congenital Heart Diseases?
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flow into an abnormal location with frequent overflow of blood in that area. Atrial septal defects (ASD) Defect in the atrial septum. Occurs in 8-12% of CHD. There are 4 types: ostium primum, ostium secundum, sinus venosus and coronary sinus. Blood is shunted from left to right with right sided volume overload which causes dilatation of right sided structures. Clinical Patients are often asymptomatic with incidental murmur. Murmur – Normal S1, fixed split S2, systolic ejection murmur in pulmonic area. Evaluation Electrocardiogram can show right bundle branch block with right atrial enlargement. Chest radiograph shows cardiomegaly with pulmonary artery dilatation and increased pulmonary vascular markings. Treatment – They can spontaneous close but this is not common after age 2 or if defect is> 8 mm. Small ones can be closed with devices. Lar...
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