CHD refers to heart defects present from birth, affecting heart structure or function.
Why Important?
- Some
defects cause no symptoms & are detected later.
- Some
cause cyanosis (blue baby) or heart failure
in early life.
- Advances
in surgery allow many children with CHD to survive into adulthood.
FETAL CIRCULATION
& CHANGES AFTER BIRTH
• Before Birth (Fetal Circulation)
- Lungs are not used
→ Blood bypasses lungs through special pathways:
- Foramen Ovale → Connects Right Atrium to Left Atrium
- Ductus Arteriosus → Connects Pulmonary Artery to Aorta
- Ductus Venosus → Bypasses liver
• After Birth (Newborn Circulation)
- Lungs expand → Blood must flow through
lungs for oxygenation
- Foramen Ovale & Ductus Arteriosus
close
Mnemonic: "FO-DA-DV" (Fetal Circulation Shunts)
- Foramen Ovale
- Ductus Arteriosus
- Ductus Venosus
TYPES OF
CONGENITAL HEART DISEASE (CHD)
1. CYANOTIC CHD
("Blue Baby")
• Right-to-Left Shunt → Deoxygenated Blood Enters Body
• Causes:
- Tetralogy of Fallot (TOF)
- Transposition of Great Arteries (TGA)
- Tricuspid Atresia
- Total Anomalous Pulmonary Venous
Return (TAPVR)
- Truncus Arteriosus
Mnemonic: "5 T’s of Cyanotic CHD"
- Tetralogy of
Fallot
- Transposition
of Great Arteries
- Tricuspid
Atresia
- Total
Anomalous Pulmonary Venous Return
- Truncus
Arteriosus
2. ACYANOTIC CHD
("Pink Baby")
• Left-to-Right Shunt → Extra Blood to Lungs
• Causes:
- Atrial Septal Defect (ASD)
- Ventricular Septal Defect (VSD)
- Patent Ductus Arteriosus (PDA)
- Coarctation of Aorta (Narrowing of
Aorta)
Mnemonic: "A-V-P-C" (Acyanotic CHD)
- Atrial
Septal Defect (ASD)
- Ventricular
Septal Defect (VSD)
- Patent
Ductus Arteriosus (PDA)
- Coarctation
of Aorta
MOST COMMON CHD
CONDITIONS
1. ATRIAL SEPTAL
DEFECT (ASD)
• Hole between atria (Left to Right Shunt)
• Symptoms: Fatigue, Murmur, Late Cyanosis (if untreated)
• Treatment: Surgery if large
Mnemonic: "ASD = Atrial Septum Defect"
2. VENTRICULAR
SEPTAL DEFECT (VSD)
• Hole between ventricles (Left to Right Shunt)
• Symptoms: Loud murmur, may close on its own
• Treatment: Surgery if large
Mnemonic: "VSD = Ventricular Septum Defect"
3. PATENT DUCTUS
ARTERIOSUS (PDA)
• Ductus Arteriosus fails to close after birth
• Symptoms: Continuous "machine-like" murmur
• Treatment: Indomethacin (closes PDA), Surgery if
needed
Mnemonic: "PDA = Persistent Ductus Arteriosus"
4. TETRALOGY OF
FALLOT (TOF) ("Blue Baby")
4 Defects ("PROVe"):
- Pulmonary Stenosis (Narrow artery to lungs)
- Right Ventricular Hypertrophy (Thickened RV)
- Overriding Aorta (Aorta shifted over VSD)
- Ventricular Septal Defect (Hole in ventricles)
• Symptoms:
- Cyanosis (Blue Baby)
- Clubbing of Fingers
- "Tet Spells" (Sudden
Cyanosis, Child Squats to Relieve Symptoms)
Mnemonic: "PROVe" (TOF Features)
- Pulmonary Stenosis
- Right
Ventricular Hypertrophy
- Overriding
Aorta
- VSD
DIAGNOSIS OF CHD
- ECG → Checks for heart enlargement
- Echocardiography (ECHO) → Gold standard for CHD
- Chest X-ray → Heart Size & Lung Congestion
- Cardiac Catheterization → Measures heart pressures
Mnemonic: "ECHO-X" (Tests for CHD)
- ECHO → Best
Test
- CXR → Heart
Shape
- Holter (For
Arrhythmias)
- Oxygen
Levels (Pulse Oximetry)
TREATMENT OF CHD
1. MEDICAL
TREATMENT
- Diuretics (Furosemide) → Remove Extra Fluid
- Prostaglandins (PGE1) → Keep PDA Open (For TGA)
- Indomethacin → Close PDA
Mnemonic: "DIP" (Drugs for CHD)
- Diuretics
- Indomethacin
(Closes PDA)
- Prostaglandins
(Keeps PDA Open)
2. SURGICAL
TREATMENT
- ASD, VSD, PDA Closure Surgery
- TOF Surgery (Blalock-Taussig Shunt, Complete Repair)
- Coarctation Repair (Balloon Angioplasty, Surgery)
- Heart Transplant (Severe Cases)
Mnemonic: "SAC" (Surgeries for CHD)
- Shunt
Surgery (For TOF)
- Angioplasty
(For Coarctation)
- Closure (For
ASD, VSD, PDA)
FINAL REVISION WITH MNEMONICS
- Fetal Circulation = "FO-DA-DV"
- Cyanotic CHD = "5 T’s" (TOF, TGA, TAPVR, Tricuspid Atresia, Truncus Arteriosus)
- Acyanotic CHD = "A-V-P-C" (ASD, VSD, PDA, Coarctation)
- TOF Features = "PROVe" (Pulmonary Stenosis, RVH, Overriding Aorta, VSD)
- Diagnosis = "ECHO-X" (ECHO, X-ray, Holter, Oxygen levels)
- Drugs = "DIP" (Diuretics, Indomethacin, Prostaglandins)
- Surgeries = "SAC" (Shunt, Angioplasty, Closure)
