Congenital Heart Diseases (CHD)

Definition:
The heart diseases that present at birth is called CHD.
Causes of CHD:
1. Unknown etiology
2. Chrosomal abnormality
a. Down syndrome
b. Turner syndrome
3. Antenatal illness of mother
a. Diabetes mellitus
b. Rubella infection
c. Radiation etc.
Incidence of CHD:
About 8 in 1000 births.
Classification of CHD:
1. Cyanotic CHD
a. Tertralogy of Fallot (TOF)
i. Obstruction of right ventricular outflow tract
ii. Ventricular septal defect
iii. Overriding of aorta
iv. Right ventricular hypertrophy
b. Transposition of great arteries
c. Persistence truncus arteriosus
d. Tricuspid atresia
e. Ebstein anomaly
f. Total anomalous pulmonary venous drainage
 2. Acyanotic CHD
a. Ventricular septal defect
b. Atrial septal defect
c. Patent ductus arteriosus
d. Coarction of aorta
e. Pulmonary stenosis
f. Aortic stenosis
Ventricular septal defect
Commonest congenital heart disease.
The defect in in the intraventricular septum.
Clinical features of VSD:
Symptoms:
1. Small defect:
a. Patient usually remain asymptomatic with normal growth and
development
b. Diagnosis is always incidental
2. Large defect:
a. Dyspnoea at rest or on exertion
b. Poor feeding
c. Poor weight gain
d. Easy fatigability
e. Profuse sweating
f. Recurrent respiratory tract infection
g. Cyanosis is usually absent
Signs:
1. Appearance: Sick looking, often malnourished
2. Respiratory rate: Increased
3. Pulse: Increased
4. Blood pressure: Normal
5. Pedal oedema: Absent
Atrial septal defect
Atrial septal defect is an abnormal communication between right and left atria
due to defect in atrial septum.
Clinical features of ASD:
Symptoms:
1. Small defect: Asymptomatic and usually diagnosed during routine health
checkup.
2. Large defect:
a. Easy fatigability
b. Increased sweating
c. Poor feeding
d. Poor weight gain
e. Recurrent respiratory tract infection
Signs:
1. Appearance: Usually Normal
2. Heart rate: Normal
3. Respiratory rate: Normal
4. Weight and height: Age appropriate.

Patent ductus arteriosus

It is an abnormal communication persists between aorta and pulmonary tract.
This results from failure of complete closure of fetal ductus arteriosus.
Clinical features of PDA:
Symptoms:
1. Small defect: Asymptomatic
2. Large defect:
a. Poor feeding
b. Poor weight gain
c. Dyspnea
d. Profuse sweating with crying
e. Recurrent respiratory tract infection.
Signs:
1. Appearance: May be normal or distressed
2. Heart rate: Increased
3. Respiratory rate: Increased
4. Pulse: High volume pulse