Cardiovascular Medicine Book

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Congenital Heart Disease CausesAka: Cyanotic Congenital Heart Disease, Acyanotic Congenital Heart Disease

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  1. See also
    1. Congenital Heart Disease
  2. Most Common Etiologies
    1. Cyanotic Congenital Heart Disease (5 T's)
      1. Transposition of the Great Vessels
      2. Tetralogy of Fallot
      3. Tricuspid valve atresia
      4. Total anomalous pulmonary venous return
      5. Truncus arteriosus
    2. Acyanotic Congenital Heart Disease: Left to right shunt
      1. Ventricular Septal Defect
      2. Atrial Septal Defect
      3. Patent Ductus Arteriosus
  3. Presentation: Week 1
    1. Transient Myocardial Ischemia
    2. Dysrhythmias
    3. Arteriovenous fistula
      1. Increased Pulses
    4. Aortic Coarctation (Interrupted aortic arch)
      1. Asymmetric pulses
    5. Aortic Stenosis
      1. Decreased pulses
      2. Left Ventricular Hypertrophy
    6. Hypoplastic left heart Syndrome
      1. Most common CHF cause in first week
      2. Decreased pulses
      3. Right Ventricular Hypertrophy
      4. Hyperactive precordium
    7. Myocarditis
      1. Decreased pulses
      2. Right Ventricular Hypertrophy
      3. Decreased precordium
  4. Presentation: Weeks 2 to 4
    1. General
      1. Onset with drop in pulmonary vascular resistance
      2. Pressure drops enough to allow left to right shunt
    2. Acyanotic (PaO2 >150 on 100% O2)
      1. Coarctation of Aorta
        1. Most common CHF cause in first 2-4 weeks
      2. Aortic Stenosis
      3. Myocarditis
      4. Endocardial fibroelastosis
      5. Patent Ductus Arteriosus
      6. Aortopulmonary Window
      7. Arteriovenous fistula
      8. Ventricular Septal Defect
      9. Atrioventricular canal defects
    3. Cyanotic (PaO2 <150 on 100% O2)
      1. Hypoplastic left heart Syndrome (Uniformly fatal)
      2. Total Anomalous pulmonary venous return
      3. Truncus arteriosus
      4. Transposition and VSD
      5. Tricuspid atresia and VSD
      6. Single Ventricle
  5. Presentation: Left Sided Obstructive Disease
    1. Hypoplastic Left Heart
      1. Uniformally fatal
    2. Critical Aortic Stenosis
    3. Aortic Coarctation
  6. Presentation: Congestive Heart Failure
    1. Large Ventricular Septal Defect (VSD)
    2. Large Patent Ductus Arteriosus (PDA)
    3. Endocardial Cushion Defect
  7. References
    1. Saenz (1999) Am Fam Physician 59(7):1857
    2. Cyran (1998) PREP review lecture, October, Phoenix

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