CONGENITAL HEART DISEASE (CHD)
DEFINITION
Structural abnormalities of the heart and proximal part of the great blood vessels present at birth. Congenital heart disease (CHD) also called congenital heart defects usually manifests in childhood but may pass unrecognized and not present until adult life. Defects that are well tolerated such as atrial septal defects (acyanotic), may cause no symptoms until adult life, or may be detected incidentally on routine examination or chest x-ray.
ETIOLOGY or CAUSES
The causes of congenital heart diseases are as outlined below:
Mostly unknown
Defective genes
Environmental teratogenes e.g. radiation
Chromosomal aberrations e.g. Down's syndrome
Maternal rubella
Maternal drugs & alcoholism
CLASSIFICATIONS OF CHD
The classifications of CHD is mostly based on the presence or absence of cyanosis and the pulmonary blood flow (PBF)Cyanosis can be assessed clinically
Pulmonary blood flow can be assessed by chest X-ray.
CATEGORY 1 CHD
Acyanotic CHD with increased PBFUsually left to right shunt lesions
Ventricular Septal Disease
Atrial Septal Disease
Patent Ductus Arteriosus
Uncommon lesions
Atrioventricular septal defect
Aortopulmonary window
Ruptured sinus of valsava aneurysm
Coronary artery fistula
Partial anomalous pulmonary venous connection
CATEGORY 2 CHD
Acyanotic lesions with normal Pulmonary Blood FlowCoarctation of aorta
Interrupted aortic arch
Congenital aortic stenosis/ insufficiency
Congenital pulmonary stenosis/ insufficiency
CATEGORY 3 CHD
Cyanotic lesions with decreased Pulmonary blood flowNormal heart size
Fallot’s tetralogy and variant
Increased heart size
Ebstein’s anomaly
Tricuspid atresia
Pulmonary stenosis with Atrial Septal Defect
CATEGORY 4 CHD
Cyanotic heart disease with increased PBFUsually there is admixture of systemic and pulmonary blood.
Total anomalous pulmonary venous connection
Truncus arteriosus
Transposition of great vessels
Single ventricle
Double outlet right ventricle
Common types of Congenital Heart Disease
- Atrial Septal Defect
- Ventricular Septal Defect
- Patent Ductus Aarteriosus
- Coarctation of the aorta
- Tetralogy of Fallot ( TOF )
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