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Clinical Sciences III
Aortic Stenosisobstruction to flow
between left ventricle and aorta
Causes:Muscular
obstruction below aortic valve
Obstruction at valve itself **(BAV)
Aortic narrowing above the valve
Signs and SymptomsMild to moderate:
Detectable heart murmur
Often no symptoms
Severe: Newborn = heart
failure Older child =
Chest pain Lightheadedness Fainting spells with
exercise
Aortic Stenosis
Treatment for Aortic StenosisPalliative & depends
on type of valve abnormalityBalloon dilation
valvuloplastyValvotomyRoss procedureKonno procedure
Atrial Septal DefectHole in septum that
divides the chambers of the heart
Untreated…may cause problems in adulthoodPulmonary
hypertensionCHFArtial arrhythmias Inc risk of stroke
Atrial Septal Defect Often no symptomsLarge defect
SOBEasy fatigabilityPoor growth
Heart murmurTreatment
Closes on its own (to age 3)
Open heart surgery Close with sutures/patch Amplatzer Septal
Occluder
Hypoplastic Left Heart SyndromeComplex cardiac defect
seen in newbornAll structures on left
side of heart underdeveloped
S & S O2 saturations,
cyanosis, respir distressWeak pulsesLethargy, poor feeding
– ultimately severe shock
TreatmentCardiac
transplantationStaged
ReconstructionNorwood ProcedureGlenn ProcedureFontan
Patent Ductus Arteriosus Ductus arteriosus
BV present in babies while in womb
Should close within hours after birth Does not in patent
ductus arteriosus More common in
preemies, but can happen in term infants
Treatment Meds to promote
closure Surgical ligation
Tetralogy of FallotPulmonary stenosisVentricular septal
defectOverriding aortaRight ventricular
hypertrophy
Signs & symptomsLoud murmur / cyanosis
TreatmentSurgical correction
Transposition of Great ArteriesAorta and Pulmonary
Artery arise from wrong structures
May have other defectsVSDAbnormal branching
pattern of coronary arteries
Narrowing below pulmonary valve
Treatmentsurgical
VATER or VACTERL AssociationV = vertebraA = anal atresiaC = cardiac
abnormalitiesTE =
tracheoesophogeal fistula
R = renal abnormalities
L = limb anomalies
Usually have 3 or more of these abnormalities
Many babies born small and have difficulty gaining wt.
Tend to have normal intelligence