Congenital heart defects

 

Congenital heart defects : The defects in hearts structure with which a baby born are known as congenital heart defects, these are acquired due to malformation of heart during embryogenesis.

Classification on base of location of defects: On base of location these defects can be classified as;

1.      Ventricular septal defects: These arise when there is defect or malformation in formation of Inter-Ventricular septum. These may be further classified as:

a.      Defects in membranous part of Inter-Ventricular septum This is relatively more common, almost 80 to 85% of congenital heart defect cases are due to this.

b.      Defects in muscular portion of Inter-Ventricular septum These cases are less common , almost 10% to 15% are cases get rise due to it.

         Categories of inter-Ventricular septal defects:  On base of defetc’s size, these can be categorize as;

        ., Minor VSD: Have less than 3mm size. Resolves spontaneously.

        ., Average VSD: Size is between 3 to 6mm. Require surgery.

        ., Major VSD: Size is larger than 6mm. Also require surgery.

2.      Arterial septal defects (ASD): These are defects/malformation of Inter-atrial septum.

On base of location of defects, these also can be divided into;

a.      Ostium secondum Most common. Almost 75% cases of ASD belong to it.

b.      Ostium Premium

c.       Sinus Venuses defect

3.      Patent ductus Arteriosus: This  the presence of abnormally unclosed Ductus Arteriosus, Which is normally open during intra-Uterine, but with birth it spontaneously get closed, and converts into Ligamentum Arteriosus. But in some cases it remains open, which leads to congenital abnormal condition known as PDA.  

The first line treatment is to provide anti-prostaglandin or prostaglandin inhibitors. And tge surgery(Ligation) is also indicated in sever cases.

4.      Obstructions of cardiac valves : These obstruction or abnormalities may be;

a.      Pulmonary Valve Stenosis: Pulmonary Valves are  congenitally abnormally hardened. This will cause less blood flow towards lungs, Blood will dam in right ventricle.

b.      Aortic valve stenosis:  In this condition aortic valve is abnormal. Will cause the damming of blood in left ventricle, this is most dangerous because blood flow and oxygen supply will get insufficient or deficient.

c.       Abnormality of Bicuspid valve

d.      Abnormality of Tricuspid valve.

5.      Coarctation of Aorta:  Congenitally narrowing occur at any point in arc of aorta. This cause increase in blood pressure and may also leads to Aortic aneurism.

It can be categorize to two types on base of Coarctation location.

a.      Pre-ductal Coarctation: More dangerous because it effects blood flow of whole body.

b.      Post-Ductal Coarctation : Less sever because it don't effect blood flow and pressure of upper body regions like head etc.

6.      Transposition of Greater arteries: In this, the greater arteries( Aorta and Pulmonary arteries) replace each other's origins. Means Pulmonary artery get rise from left ventricle and Aorta get rise from right ventricle.  It is most dangerous form of Congenital heart diseases, almost 50% babies dies in their first month of lives, and 90% in first year.

In this condition, other congenital heart defects like left to right shunting and PDA little bit help survival.  Surgery is also possible and successful.

7.      Tetralogy of Fallot: In this condition four congenital heart defects are present simultaneously

a.      Pulmonary Valve Stenosis

b.      Right ventricle hypertrophy

c.       Ventricular septal defect

d.      Misplacement of aorta

These leads to Cyanosis, Arrhythmias and poor development or growth.