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Background
Various congenital abnormalities (congenital anomaly).
Congenital Heart Disease (CHD) is the most common abnormality.
In the United States, the prevalence of congenital heart disease
around 8-10 of 1,000 live births, with a third of them manifest in
critical condition in the first year of life and 50% of the gravity of the
first month of life ends with death.
In Indonesia, with a population of 200 million inhabitants and a live
birth rate of 2%, it is estimated there are about 30,000 patients with
CHD.
A-CHD
- Increased pulmonary blood flow
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA)
Endocardial cushion defects (ECD)
- Normal pulmonary blood flow
Pulmonary Stenosis (PS)
Aortic Stenosis (AS)
Coarctatio Aorta (CoA)
Physical Examination
Dyspnoe
Impaired growth
More to VSD
Thorax: cardiomegaly, increased pulmonary vascularity, hilar blood vessels
thicken
ECG: an increase in the activity of the left ventricle, mitral P (enlargement
of the left atrium), when pulmonary hypertension right ventricular
hypertrophy
Echocardiography: the direction of the shunt, the pressure a.pulmonalis
Cardiac catheterization and angiography: to prove the increase in oxygen
saturation in the right ventricle. Angiography shows the magnitude and
direction of the shunt, and detecting aortic regurgitation
Primum ASD
There is a gap at the bottom of the atrial
septum, namely the atrial septum primum.
Clinical features:
Dyspnoe and recurrent respiratory tract infections
Physical examination:
There noisy "systolic ejection" on the left second
intercostal space
Physical examination
Radiology
Medium
Heavy
asimptomatik
Palpable vibration
noise in the second
intercostal left sternal
in
SA SUPRAVALVULAR:
From the outside of the aorta
appeared normal, but the walls are
very thick, which is composed of
fibrous tissue. Aortic lumen becomes
smaller, can be up to 1/3 the normal
lumen. Ventricular hypertrophy is
often found.
Physical examination
Substernal pain
Dyspnoe
Dizziness or syncope during
the activity
Physical examination
shortness of breath,
hepatomegaly, with a small
pulse, oliguria or anuria
General handling
Conservative - MM
The objective medical therapy also to avoid the development of
pulmonary vascular obstructive disease or the development of
congestive heart failure. If it turns out heart failure and
circumstances related to lung problems still occur, diuretics and
digoxin is the indication.
Diuretics can be given is furosemide (Neonates is 0.5-1 mg/kg/day in
1-3 a day). In infants and children, the dose given was 0.5-2
mg/kg/day, in 2-4 feedings.
Conservative - MM
Surgical therapy
Conclusion
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