Professional Documents
Culture Documents
ACYANOTIC WITH A SHUNT (LEFT TO RIGHT,increased pulmonary arterial flow) Shunt at arterial level Shunt at ventricular level Shunt between aortic root and right side of heart Shunt at aortopulmonary level Shunts at more than one level CYANOTIC Increased pulmonary arterial blood flow Normal or decreased pulmonary arterial blood flow Dominant left ventricle Dominant right ventricle With pulmonary hypertension Without pulmonary hypertension Normal or nearly normal ventricles
INNOCENT MURMURS
50% of normal children have an innocent heart murmur. No symptoms & signs Due to turbulent blood flow at the origin of the great vessels Better heard in children than in adults due to: Thin chest wall in children More angulated great vessels in children More dynamic circulation in children
Types of innocent murmurs Stills murmur: Due to blood flow across the aortic valve. Heard best over the right upper sternal border. It is a systolic ejection murmur, vibratory, musical in quality. Seen in infancy to adolescence Physiologic systolic ejection murmur; Second most common. Hear best at the left mid to upper sternal border. Heard best with diaphragm due to high frequency Supraclavicular arterial bruit: Above and not below the clavicle. Louder on right due to brachiocephalic arteries branching Neonatal peripheral pulmonary stenosis(PPS): Birth to 3-6 months. Heard best at base of the heart, both axillae and the back. Due to relative small size of branch pulmonary arteries and the angle of bifurcation of the Pas
Cervical venous hum; Continuous hum. Heard over right upper sternal border. Better in sitting, disappear in supine and when pressure is applied to neck to reduce venous blood return.
CARDIAC MALPOSITIONS
DEXTROCARDIA heart on right side 4 common types: 1.Classic mirror image 2.Normal heart displaced to right 3.Congenitally corrected TGA with situs solitus 4.Situs ambiguus with splenic syndromes MESOCARDIA heart in midline of thorax
VENTRICULAR INVERSION
Congenitally corrected TGAs Visceroatrial relationship is normal but there is ventricular inversion
SHUNT AT VENTRICULAR LEVEL VSD (isolated) VSD with mild PS ( Acyanotic Fallots tetralogy) VSD with right ventricular origin of both great arteries VSD with aortic incompetence VSD with left ventricular to right atrial shunt VSD with complete interruption of aortic arch
SHUNT BETWEEN AORTIC ROOT & RIGHT HEART Coronary arteriovenous fistula Ruptured sinus of Valsalvas aneurysm
SHUNT AT AORTICOPULMONARY LEVEL PDA Aorticolpulmonary septa defect Anomalous origin of left coronary artery from pulmonary artery Truncus arteriossus with large pulmonary arteries & low pulmonary vascular resistance
SHUNT AT MORE THAN ONE LEVEL Complete endocardial cushion defect VSD with PDA VSD with ASD
THANK YOU