CHD for Web
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Transcript of CHD for Web
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Differential Diagnosisof CHD
Differential DiagnosisDifferential Diagnosisof CHDof CHD
In Slide Show mode, to advance slides, press spacebar
William Herring, M.D. © 2003
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Nine Lesions Which Produce 75% of All Severe Congenital Heart Lesions In the Neonate
Decreased flow1. Tetralogy of Fallot2. Tricuspid Atresia3. Severe Pulmonic
Stenosis4. Ebstein’s
Increased Flow5. Transposition 6. VSD
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Nine Lesions Which Produce 75% of All Severe Congenital Heart Lesions In the Neonate
Pulmonary venous hypertension7. Hypoplastic left heart8. Coarctation of the aorta9. TAPVR with infradiaphragmatic obstruction
What’s leftLeft-to-right shunts
ASDPDA
Truncus arteriosus
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Cyanotic
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Cyanosis With Decreased Vascularity
TetralogyTruncus-type IVTricuspid atresia*Transposition*Ebstein's
* Also appears on DDx of Cyanosis with ↑ Vascularity
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Ebstein’s AnomalyEbstein’s Anomaly
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CyanoticCyanotic
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Cyanosis With Increased Vascularity
Truncus types I, II, IIITAPVRTricuspid atresia*Transposition*Single ventricle
* Also appears on DDx of Cyanosis with ↓ Vascularity
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Totalanomalousvenousreturn(TAPVR)
Totalanomalousvenousreturn(TAPVR)
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Acyanotic
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Cardiomegaly with Normal Vasculature
Viral myocarditisEndocardial fibroelastosisAberrant left coronary arteryCystic medial necrosisDiabetic mother
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Acyanotic
Endocardial Cushion DefectEndocardial Cushion Defect
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CHF In NewbornImpede Return of Flow to Left Heart
Infantile coarctationCongenital aortic stenosisHypoplastic left heart syndromeCongenital mitral stenosisCor triatriatumObstruction to venous return from lungs
TAPVR from below diaphragm
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CHF In Chronologic Sequence
CHF In Chronologic Sequence
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CHF In NewbornImpede Return of Flow to Left Heart
Infantile coarctationCongenital aortic stenosisHypoplastic Left Heart SyndromeCongenital mitral stenosisCor triatriatumObstruction to venous return from lungs
TAPVR from below diaphragm
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CHF In 2nd-3rd Week
Coarctation of the aortaInterruption of the aortic arch
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CHF-later
Coarctation of the aorta –adult type
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Unknowns
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Increasedflow
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1° Pulmonary Hypertension1° Pulmonary Hypertension
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MitralStenosisMitralStenosis
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PAH
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Atrial Septal DefectAtrial Septal Defect
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Pericardial EffusionPericardial Effusion
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Normal
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Aortic StenosisAortic Stenosis
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MitralStenosisWith SeverePAH
MitralStenosisWith SeverePAH
MS
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Cyanotic
Tetralogy of FallotTetralogy of Fallot
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Tetralogy of FallotComponents of
Ventricular septal defectPulmonic stenosisOverriding aortaRight ventricular hypertrophy
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ASDASD
Acyanotic
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LA Ao
ASD
PDA
VSD
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CHFCHF
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Pulmonary Interstitial EdemaX-ray Findings
Thickening of the interlobular septaKerley B lines
Peribronchial cuffingWall is normally hairline thin
Thickening of the fissuresFluid in the subpleural space in continuity with interlobular septa
Pleural effusions
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Ventricular Septal Defect (VSD)Ventricular Septal Defect (VSD)
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AtrialSeptal Defect(ostium primum type)with PAH
AtrialSeptal Defect(ostium primum type)with PAH
MS with PAH
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PulmonicStenosisPulmonicStenosis
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Most Commons
Most common cause of CHF in newbornHypoplastic left heart syndrome
Most common cause of CHF > 2 weeksCoarctation of the aorta (infantile form)
Most common cyanotic heart diseaseTetralogy of Fallot
Most common dz associated c R archTetralogy of Fallot
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Most Commons
Most common L R shuntVentricular Septal Defect
Most common L R shunt dx’d in adultAtrial Septal Defect
Dz most commonly associated c R archTruncus arteriosus
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The End
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