CONGENITAL HEART DISEASE , TIM BẨM SINH Ở TRẺ EM, ĐH Y DƯỢC TP HCM

Bài giảng dành cho sinh viên y khoa, bác sĩ đa khoa, sau đại học. ĐH Y Dược TP Hồ Chí Minh. Definition Incidence Etiology Classification

CONGENITAL HEART DISEASE

(CHD)

Vũ Minh Phúc MD PhD.

1 Definition

2 Incidence

3 Etiology

4 Classification

1 DEFINITION

The deformities of the heart structure and vessels :

 cardiac position

 myocardium

 lateral wall and septum

 heart chambers

 valves

 systemic and pulmonary veins

 great arteries, coronary arteries

2 INCIDENCE

• In the world : 0.7-0.8% live births

– Ventricular septal defect VSD 20%

– Atrial septal defect ASD 10%

– Patent ductus arteriosus PDA 10%

– Aortic coarctation CoA 10% – Aortic stenosis AS 10%

– Tetralogy of Fallot TOF 10% – Pulmonary stenosis PS 10%

2 INCIDENCE

– Congenital heart disease : 1160 49.8%

– Other heart and vascular diseases : 242 10.3%

(Kawasaki’s disease = 121)

– Juvenile rheumatoid arthritis : 70 3% – Rheumatic fever : 16 0.6%

Total 2007 : 2330 100%

2 INCIDENCE

VSD 313 (27.0%)

Other complex CHD 42

Truncus arteriosus 6

Single Ventricle 5

Aortic Stenosis 4

Tricuspid stenosis 2

Pulmonary atresia 1

Aortic coarctation 1

Tricuspid atresia 1

1083 (93.4%)

2 INCIDENCE

• Mortality of CHD

3 ETIOLOGY

3.1 Gene and Family factor

• Gene mutation - inheredity

– Chromosome abnormalities : 13, 18, 21, 22

– Gender chromosome abnormalities : XO, XXY

• Heredity according to the Mendel’s law

3% of CHD

– Valvular deformities

– Cardiomyopathy

– Deformities of great vessels due to hereditary enzyme disturbances

3 ETIOLOGY

3.1 Gene and Family factor

• Dominant heredity

– Syndromes have CHD and many other deformities

– Only have CHD

• Romanoward

• Barlow

• DCM

• Cardiac conduction disturbance

3 ETIOLOGY

3.1 Gene and Family factor

• Recessive heredity

– Blood-relation marriage

• Friedrich

• Jervell

• Ellis Van Creveld

– Gender chromosome heredity

• Duchene disease

• Hunter syndrome

3 ETIOLOGY

3.2 From enviroment

• X ray, radioactive ray

• Wine, cocaine

• Sedatives: thalidomide, amphetamine, trimethadione

Hydantoin

Productive hormones

• Viruses: rubella, measles, HSV, CMV, Coxsackie B

• Chronic diseases: SLE, diabetes, phenylketonuria

4 CLASSIFICATION OF CHD

• General

– Innocent or normal murmurs

– Cardiac malposition

– Ventricular inversion (corrected TGA)

– Complete heart block

4 CLASSIFICATION OF CHD

• General

– Innocent or normal murmurs

– Cardiac malposition

– Ventricular inversion (corrected TGA)

– Complete heart block

• Acyanotic

– without a shunt (normal or  pulmonary blood flow (PBF))

– with left-to-right shunt ( PBF)

• Cyanotic

  PBF

– Normal or  PBF

THANKS FOR YOUR ATTENTION