Dm clinic, Congenital heart diseases

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DM ClinicCongenital heart diseases

TeacherBalachander Jayaraman

Professor Department of Cardiology

JipmerPondicherry, india

14/05/2016

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Introduction

In JIPMER,Pondicherry, India every Friday all DM cardiology resident

have clinical cardiology case discussion which is conducted by Dr

Balachander Jayaraman. I am uploading few important clinical points

which were told to us during the case discussion.

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Causes of heart failure in infancy

Post tricuspid shunt

VSD

ALCAPA

AV cannal malformations

Pure right heart failure- PPH or critical stenosis

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Symptoms of heart failure in pediatric population

Pedal oedema in Pediatric population

Periorbital odema

Increased in the liver span in the infancy first sign of LVF in the child

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Cause of resolving in heart failure in children

Development of Pulmonary hypertension

Development of pulmonary stenosis

Change in fetal haemoglobin

Decreases in the size of the shunt

LV maturation

Development of L to R shunt at atrial level

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DM clinic

Unleger - Lakes of blood in right ventricle in ALCAPA.

LAD drain into pulmonary artery

Congenital mitral regurgitation with CC-TGA

Endomyocardial fibroelastosis

Failure to thrive

Weight more affected than height. 95 percentile less

Pulmonary artery hypertension causes activation of J receptor. Hypoxia

causes J receptor activation.

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Causes of heart failure late in congenital heart disease

Anemia

Aortic regurgitation

Infective endocarditis

Annual dilatation, mitral regurgitation.

AV cannal malformations causes early PAH

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DM clinic

Heart failure only says if congestive symptoms are presen

DOE, PND, Orthopnoea Than use words LV dysfunction

Right ventricular dysfunction Presence of TR

Right ventricular failure causes cyanosis more in lower limb than in

upper limb in PDA with reverse differential cyanosis

PDA With Pulmonary artery hypertension with open PFO causes cyanosis

equal in all four limb

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DM clinic

Wide pulse pressure with PAH- AP windows,PDA, Truncus

arteriosus

Mixed frequency indicates increased flow with gradient across valve

Systolic and diastolic murmur

Pulmonary regurgitation murmur

Large AP windows

PDA

Truncus arteriosus

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DM clinic

DORV Ecg Prolonged PR with RBBB

ECG by burch and limsa for congenital heart disease (Book)

Peripheral pruning means absent of middle third right pulmonary

artery

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DM Clinic

PCI wire is floppy, intermediate,

Right heart catheterization Cournard.

Gudalelumen

JL catheter

Berman catheter No end holes.

Pentalumen for pacing

DES Daily drug release, how long last, polymer degradation rate.

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THANK YOU