dm clinic, congenital heart diseases
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1
DM ClinicCongenital heart diseases
TeacherBalachander Jayaraman
Professor Department of Cardiology
JipmerPondicherry, india
14/05/2016
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Introduction
In JIPMER,Pondicherry, India every Friday all DM cardiology resident
have clinical cardiology case discussion which is conducted by Dr
Balachander Jayaraman. I am uploading few important clinical points
which were told to us during the case discussion.
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Causes of heart failure in infancy
Post tricuspid shunt
VSD
ALCAPA
AV cannal malformations
Pure right heart failure- PPH or critical stenosis
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Symptoms of heart failure in pediatric population
Pedal oedema in Pediatric population
Periorbital odema
Increased in the liver span in the infancy first sign of LVF in the child
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Cause of resolving in heart failure in children
Development of Pulmonary hypertension
Development of pulmonary stenosis
Change in fetal haemoglobin
Decreases in the size of the shunt
LV maturation
Development of L to R shunt at atrial level
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DM clinic
Unleger - Lakes of blood in right ventricle in ALCAPA.
LAD drain into pulmonary artery
Congenital mitral regurgitation with CC-TGA
Endomyocardial fibroelastosis
Failure to thrive
Weight more affected than height. 95 percentile less
Pulmonary artery hypertension causes activation of J receptor. Hypoxia
causes J receptor activation.
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Causes of heart failure late in congenital heart disease
Anemia
Aortic regurgitation
Infective endocarditis
Annual dilatation, mitral regurgitation.
AV cannal malformations causes early PAH
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DM clinic
Heart failure only says if congestive symptoms are presen
DOE, PND, Orthopnoea Than use words LV dysfunction
Right ventricular dysfunction Presence of TR
Right ventricular failure causes cyanosis more in lower limb than in
upper limb in PDA with reverse differential cyanosis
PDA With Pulmonary artery hypertension with open PFO causes cyanosis
equal in all four limb
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DM clinic
Wide pulse pressure with PAH- AP windows,PDA, Truncus
arteriosus
Mixed frequency indicates increased flow with gradient across valve
Systolic and diastolic murmur
Pulmonary regurgitation murmur
Large AP windows
PDA
Truncus arteriosus
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DM clinic
DORV Ecg Prolonged PR with RBBB
ECG by burch and limsa for congenital heart disease (Book)
Peripheral pruning means absent of middle third right pulmonary
artery
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DM Clinic
PCI wire is floppy, intermediate,
Right heart catheterization Cournard.
Gudalelumen
JL catheter
Berman catheter No end holes.
Pentalumen for pacing
DES Daily drug release, how long last, polymer degradation rate.
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THANK YOU
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