Clinical Sciences III

Aortic Stenosisobstruction to flow

between left ventricle and aorta

Causes:Muscular

obstruction below aortic valve

Obstruction at valve itself **(BAV)

Aortic narrowing above the valve

Signs and SymptomsMild to moderate:

Detectable heart murmur

Often no symptoms

Severe: Newborn = heart

failure Older child =

Chest pain Lightheadedness Fainting spells with

exercise

Aortic Stenosis

Treatment for Aortic StenosisPalliative & depends

on type of valve abnormalityBalloon dilation

valvuloplastyValvotomyRoss procedureKonno procedure

Atrial Septal DefectHole in septum that

divides the chambers of the heart

Untreated…may cause problems in adulthoodPulmonary

hypertensionCHFArtial arrhythmias Inc risk of stroke

Atrial Septal Defect Often no symptomsLarge defect

SOBEasy fatigabilityPoor growth

Heart murmurTreatment

Closes on its own (to age 3)

Open heart surgery Close with sutures/patch Amplatzer Septal

Occluder

Hypoplastic Left Heart SyndromeComplex cardiac defect

seen in newbornAll structures on left

side of heart underdeveloped

S & S O2 saturations,

cyanosis, respir distressWeak pulsesLethargy, poor feeding

– ultimately severe shock

TreatmentCardiac

transplantationStaged

ReconstructionNorwood ProcedureGlenn ProcedureFontan

Patent Ductus Arteriosus Ductus arteriosus

BV present in babies while in womb

Should close within hours after birth Does not in patent

ductus arteriosus More common in

preemies, but can happen in term infants

Treatment Meds to promote

closure Surgical ligation

Tetralogy of FallotPulmonary stenosisVentricular septal

defectOverriding aortaRight ventricular

hypertrophy

Signs & symptomsLoud murmur / cyanosis

TreatmentSurgical correction

Transposition of Great ArteriesAorta and Pulmonary

Artery arise from wrong structures

May have other defectsVSDAbnormal branching

pattern of coronary arteries

Narrowing below pulmonary valve

Treatmentsurgical

VATER or VACTERL AssociationV = vertebraA = anal atresiaC = cardiac

abnormalitiesTE =

tracheoesophogeal fistula

R = renal abnormalities

L = limb anomalies

Usually have 3 or more of these abnormalities

Many babies born small and have difficulty gaining wt.

Tend to have normal intelligence