先天性心脏病（英文54p）.ppt

Congenital Heart Disease Epidemiology of CHD Prevalence CHD occurs in 0.5-0.8% of live births; The incidence is higher among stillborns死产(3-4%), abortuses流产(10-25%), and premature infants (about 2% excluding PDA); About 2-3 in 1,000 newborn infants will be symptomatic with heart disease in the first year of life. Epidemiology of CHD Prevalence The diagnosis is established by 1 week of age in 40-50% of patients with CHD and by 1 month of age in 50-60% patients; With the advances in both palliative姑息and corrective surgery of the last 20 years, the number of children with CHD surviving to adulthood has increased dramatically; Epidemiology of CHD Prevalence Despite these advances, CHD remains the leading cause of death in children with congenital malformations; Most congenital defects are well tolerated in the fetus because of the parallel nature of the fetal circulation. Epidemiology of CHD Etiology The cause of most CHD is unknown. Genetic factors play some role in CHD. About eight percent of cases result mainly from genetic factors. The heart defect is usually part of a chromosomal disorder such as Downs syndrome. However, no specific gene locus for CHD has been identified. Epidemiology of CHD Etiology A child born to a parent with CHD has a substantially大体上increased likelihood of having a similar congenital lesion. The risk may be as high as 15 percent. For certain lesions, there appears to be a greater risk of transmission from the mother than from the father. Epidemiology of CHD Etiology About two percent of cases of CHD are primarily the result of environmental or external factors. Such factors include rubella风疹infection and ingestion of certain drugs, such as lithium锂. CHD is a prominent component of the fetal alcohol syndrome. The etiologic role of other agents, such as anticonvulsant medications and exogenous外源female sex hormones, is uncertain. Noninvasive Diagnostic Studies Chest X ray The location of the heart The size of the heart The relationshi