先天性心脏病y1.ppt

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先天性心脏病y1

Introduction CHD is defined as an abnormality in circulatory structure or function that is present at birth, even if it is discovered much later. Incidence: 6.9 ‰ in alive neonatal. 150,000 neonatal suffer from CHD in China per year. New treatments:catheterization、 development of operation, etc. Object and Request Familiar with the etiology and classification of CHD. Master the hemodynamics 、clinical manifestation and diagnosis of common complications in VSD, ASD, PDA and TOF. Etiology Internal factors: gene mutation or chromosome aberration. A defect in the long arm of chromosome 22 associated with the DiGeorge, Shprintzen, and conotruncal anomaly face syndromes.These children tend to have either interrupted aortic arch or conotruncal abnomalities such as TOF or double outlet right ventricle. External factors: intraureteral infection(rubella virus) 、ray、drug、metabolic diseases、intraureteral hypoxia. The incidence in children of affected mothers may be as high as 10%-15%. Classification Common CHD in Clinic Pathobiology Hemodynamics Before pulmonary hypertension Hemodynamics Clinical Manifestation Symptoms: frequent respiratory infections, grow slowly ,poor weight, dyspnea, exercise intolerance, fatigue, hoarseness (PA press recurrent laryngeal nerve). Signs:pansystolic murmur ,loud Ⅲ-Ⅳ, harsh wide conduction, 3rd-4th intercostal space at left sternal border. P2 accent. Examination X-ray: aortic knob smaller than normal main PA segment protrusion LV enlargement increase lung markings ECG: LV hypertrophy US : interventricular septum intermitted Complications and Treatment Complications bronchopneumonia congestive heart failure pulmonary edema infectious endocarditis Treatment minor defect:may avoid operation. media defect:operation at 5-6 years old. major defect with complications: operation at 6m-2y. Atrial Septal Defect (ASD) 5%-10% Bioanatomy: 1. o

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