Understanding Different Types of Congenital Heart Defects


Let's explore the various types of congenital heart defects, starting with Tetralogy of Fallot. This condition is characterized by four key abnormalities, which can be remembered with the acronym "RAPS":

  • Right ventricular hypertrophy (enlargement)
  • Aorta displacement
  • Pulmonary stenosis (narrowing)
  • Septal defect, specifically a ventricular septal defect (VSD)

Patients with Tetralogy of Fallot often experience "Tet spells," where they become cyanotic (bluish skin due to lack of oxygen). To alleviate these spells, the knee-to-chest position is recommended.

Next is Ventricular Septal Defect (VSD), where there is a hole in the wall (septum) between the right and left ventricles. You can remember this condition with the word "HOLE." Patients with VSD may develop heart failure and pulmonary hypertension, often leading to frequent lung infections, poor growth, and weight gain. Additionally, extra heart sounds, or murmurs, can often be heard.

Then there's Atrial Septal Defect (ASD), similar to VSD, but the hole is between the right and left atria. While ASD carries similar risks to VSD, be particularly vigilant for the risk of stroke and the presence of a mid-systolic murmur at the second intercostal space, just to the left of the sternum.

Another significant defect is the Transposition of the Great Arteries (TGA). Here, the two major arteries—the aorta and the pulmonary artery—are swapped. The key word to remember is "SWAP." Babies born with this defect have severe and persistent cyanosis. It’s crucial to monitor their heart rate, rhythm, oxygen saturation, and respiratory rate. Alprostadil is often administered to keep the ductus arteriosus open until surgery can be performed, which may involve procedures like balloon atrial septostomy or an arterial switch.

Aortic Coarctation involves narrowing within the aorta. Before the narrowing, there's high blood pressure, which can lead to heart failure, while after the narrowing, the pressure drops. Surgery to remove the narrowed section and reconnect the ends of the aorta is typically performed by age two. However, if the artery narrows again later, a balloon angioplasty might be needed to reopen it.

Lastly, Patent Ductus Arteriosus (PDA) occurs when the ductus arteriosus, a normal fetal blood vessel, fails to close after birth, increasing pulmonary blood flow. A telltale sign of PDA is a continuous, machinery-like murmur. Treatment options include medications like indomethacin or ibuprofen, which may help close the duct, or surgery if the condition persists.

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