CONGENITAL HEART DISEASE

1

• CONGENITAL HEART DISEASE
• Judith Huntley
• Childrens Cardiac Nurse Specialist

2

• Present from birth
• Incidence in full term live born infants is
  between 4 and 9 / 1000
• Each year there are about 1.5 million new cases
  worldwide.
• It is the most common congenital condition
  diagnosed in newborns.

3

• The prognosis for children with congenital heart
  disease has improved dramatically over the last
  20 years.
• In 1986 60 of deaths from congenital heart
  disease occurred in the first year of life
• In the 1990s the majority of deaths occurred in
  adults over the age of 20.
• It is predicted that 78 of the babies born with
  congenital heart disease today will survive into
  adulthood.

4
Aetiology

• Exact cause of most incidences is unknown
• Defects occur when there is abnormal embryonic
  development or persistence of foetal circulation
  past delivery

5
Some possible risk factors in pregnancy are

• Use of certain prescription drugs
• eg. Carbamazapine
• Use of illegal drugs
• Use of alcohol
• Foetal/maternal infection
• eg. Rubella
• vaccination has reduced the number of
  children born with rubella syndrome in the last
  two decades. Reduced uptake of the MMR vaccine
  could allow congenital rubella to increase again.

6

• Maternal dietary deficiencies
• Hereditary/familial tendencies
• Often associated with other congenital problems
• eg. Downs Syndrome
• 40 of babies with Downs Syndrome will
• have a heart defect

7
Structural defects can be divided into 2 main
categories

• ACYANOTIC
• These defects can be obstructive
• Pulmonary Stenosis
• Aortic Stenosis
• Coarctation of the Aorta

8

• left to right shunts
• Atrial Septal Defect
• Ventricular Septal Defect
  
• Persistant Ductus Arteriosus
• There is no mixing of oxygenated and
  deoxygenated blood in these lesions.

9

• CYANOTIC
• Right to left shunts
• Tetralogy of Fallots
• Tricuspid Atresia
• Transposition of Great Arteries
• Deoxygenated blood mixes with oxygenate blood

10
Diagnosis

• HISTORY
• Poor weight gain
• Poor feeding
• Frequent respiratory problems
• Fatigue
• cyanosis

11

• PHYSICAL
• Cyanosis
• Pallor
• Behaviour
• Dyspnoea
• Heart rate
• Murmur
• Hepatomegaly
• Pulses

12

• CHEST X-RAY
• Size of heart
• Shape of heart
• ECHO
• Structure and function

13

• ECG
• Arrhythmia
• Electrolyte imbalance
• Myocardial hypertrophy / damage
• CARDIAC CATHETER
• Diagnostic / theraputic

14

• What is a murmur?
• What does having a murmur mean?
• A murmur is a noise made by blood moving through
  the heart.
• A murmur does not automatically mean that
  someone has a heart defect
• Murmurs can be INNOCENT and caused by normal flow
  of blood around the heart

15
(No Transcript)
16
Heart Failure

• Inability of the heart to pump an adequate amount
  of oxygenated blood to the systemic circulation
  to meet the bodies metabolic demands.
• Many children with a congenital heart defect will
  suffer from a greater or lesser degree of heart
  failure.

17

• Signs Symptoms
• Tachycardia
• Tachypnoea
• Hepatomegaly
• Cardiomegaly
• Cough
• Sweating
• Oedema
• Vomiting

18
(No Transcript)