Differential Diagnosis of CHD Differential Diagnosis of CHD In Slide

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  • Differential Diagnosisof CHD

    Differential DiagnosisDifferential Diagnosisof CHDof CHD

    In Slide Show mode, to advance slides, press spacebar

    William Herring, M.D. 2003

  • Nine Lesions Which Produce 75% of All Severe Congenital Heart Lesions In the Neonate

    Decreased flow1. Tetralogy of Fallot2. Tricuspid Atresia3. Severe Pulmonic

    Stenosis4. Ebsteins

    Increased Flow5. Transposition 6. VSD

  • Nine Lesions Which Produce 75% of All Severe Congenital Heart Lesions In the Neonate

    Pulmonary venous hypertension7. Hypoplastic left heart8. Coarctation of the aorta9. TAPVR with infradiaphragmatic obstruction

    Whats leftLeft-to-right shunts

    ASDPDA

    Truncus arteriosus

  • Cyanotic

  • Cyanosis With Decreased Vascularity

    TetralogyTruncus-type IVTricuspid atresia*Transposition*Ebstein's

    * Also appears on DDx of Cyanosis with Vascularity

  • Ebsteins AnomalyEbsteins Anomaly

  • CyanoticCyanotic

  • Cyanosis With Increased Vascularity

    Truncus types I, II, IIITAPVRTricuspid atresia*Transposition*Single ventricle

    * Also appears on DDx of Cyanosis with Vascularity

  • Totalanomalousvenousreturn(TAPVR)

    Totalanomalousvenousreturn(TAPVR)

  • Acyanotic

  • Cardiomegaly with Normal Vasculature

    Viral myocarditisEndocardial fibroelastosisAberrant left coronary arteryCystic medial necrosisDiabetic mother

  • Acyanotic

    Endocardial Cushion DefectEndocardial Cushion Defect

  • CHF In NewbornImpede Return of Flow to Left Heart

    Infantile coarctationCongenital aortic stenosisHypoplastic left heart syndromeCongenital mitral stenosisCor triatriatumObstruction to venous return from lungs

    TAPVR from below diaphragm

  • CHF In Chronologic Sequence

    CHF In Chronologic Sequence

  • CHF In NewbornImpede Return of Flow to Left Heart

    Infantile coarctationCongenital aortic stenosisHypoplastic Left Heart SyndromeCongenital mitral stenosisCor triatriatumObstruction to venous return from lungs

    TAPVR from below diaphragm

  • CHF In 2nd-3rd Week

    Coarctation of the aortaInterruption of the aortic arch

  • CHF-later

    Coarctation of the aorta adult type

  • Unknowns

  • 31

    Increasedflow

  • 1 Pulmonary Hypertension1 Pulmonary Hypertension

  • MitralStenosisMitralStenosis

  • 26

    PAH

  • Atrial Septal DefectAtrial Septal Defect

  • Pericardial EffusionPericardial Effusion

  • 17

    Normal

  • Aortic StenosisAortic Stenosis

  • MitralStenosisWith SeverePAH

    MitralStenosisWith SeverePAH

    MS

    33

  • Cyanotic

    Tetralogy of FallotTetralogy of Fallot

  • Tetralogy of FallotComponents of

    Ventricular septal defectPulmonic stenosisOverriding aortaRight ventricular hypertrophy

  • ASDASD

    Acyanotic

  • LA Ao

    ASD

    PDA

    VSD

  • CHFCHF

  • Pulmonary Interstitial EdemaX-ray Findings

    Thickening of the interlobular septaKerley B lines

    Peribronchial cuffingWall is normally hairline thin

    Thickening of the fissuresFluid in the subpleural space in continuity with interlobular septa

    Pleural effusions

  • Ventricular Septal Defect (VSD)Ventricular Septal Defect (VSD)

  • 35

    AtrialSeptal Defect(ostium primum type)with PAH

    AtrialSeptal Defect(ostium primum type)with PAH

    MS with PAH

  • PulmonicStenosisPulmonicStenosis

  • Most Commons

    Most common cause of CHF in newbornHypoplastic left heart syndrome

    Most common cause of CHF > 2 weeksCoarctation of the aorta (infantile form)

    Most common cyanotic heart diseaseTetralogy of Fallot

    Most common dz associated c R archTetralogy of Fallot

  • Most Commons

    Most common L R shuntVentricular Septal Defect

    Most common L R shunt dxd in adultAtrial Septal Defect

    Dz most commonly associated c R archTruncus arteriosus

  • The End

  • Cardiomegaly with Normal VasculatureUnknownsTetralogy of FallotComponents ofPulmonary Interstitial EdemaX-ray FindingsMost CommonsMost Commons