Prepared by: Dr.

Majid Al-Homiedan

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL PULMONARY BLOOD FLOW

In the more common adult‌ type, the aortic narrowing occurs at or just distal to the level of the ductus arteriosus (double bulge represents prestenotic and poststenotic dilatation). In the infantile variety, there is a long segment of narrowing lying proximal to the ductus (obligatory right-to-left shunt and early congestive heart failure). There is a relatively high incidence of coarctation in women with Turner's syndrome. Characteristic double bulge in the region of the aortic knob (figure-3 sign on plain chest radiographs and reverse figure-3, or figure-E, sign on the barium-filled esophagus). There may be rib notching (usually involving the posterior fourth to eighth ribs) but rarely developing before age 6 years. OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL DDX
PULMONARY BLOOD FLOW

Valvular, subvalvular, and supravalvular types. Bulging of the right superior mediastinal silhouette (poststenotic dilatation of the ascending aorta) is often seen with valvular stenosis. Increased convexity or prominence of the left heart border (overall heart size often normal). Substantial cardiomegaly reflects left ventricular failure and dilatation.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL PULMONARY BLOOD FLOW

Common anomaly found in isolated form or in combination with other abnormalities. The stenosis is most common at the level of the pulmonary valve (supravalvular or infundibular stenosis can occur). Must be differentiated from normal idiopathic poststenotic dilatation of the pulmonary artery in adolescents and young adults, especially women. Poststenotic dilatation of the pulmonary artery, often associated with dilatation of the left main pulmonary artery. The heart size is initially normal (right ventricular hypertrophy and dilatation if severe pulmonary stenosis causes systolic overloading of the right ventricle).

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL PULMONARY BLOOD FLOW

Diffuse thickening of the left ventricular endocardium with collagen and elastic tissue. A common cause of cardiac failure during the first year of life. The pulmonary vascularity remains normal until congestive heart failure supervenes.

Striking globular cardiac enlargement (often with left-sided prominence); small aortic knob.
DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL PULMONARY BLOOD FLOW

Includes hypoplastic left heart syndrome, mitral stenosis and insufficiency, aortic insufficiency, cor triatriatum, aberrant pulmonary origin of left coronary artery, and cardiomyopathy.

Hypoplastic left heart syndrome
DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH NORMAL PULMONARY BLOOD FLOW

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