2-central--->definition causes : A: Methemoglobinemia
B:Disorders of O2 penetration into circulatory system C:Rt to Lt
shunt at cardiac or pulmonic level
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Clubbing
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Congenital cardiac disease causes of finger clubbing Finger
clubbing can also be caused by congenital cardiac diseases
including: Tetralogy of Fallot (combination of four structural
defects) Total anomalous pulmonary venous return (TAPVR; rare
condition in which the pulmonary veins do not empty into the heart)
Transposition of the great vessels (rare condition in which the
major vessels entering or leaving the heart are misconnected
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Respiratory disease causes of finger clubbing Finger clubbing
may be caused by respiratory diseases including: Bronchiectasis
(destruction and widening of the large airways) Chronic obstructive
pulmonary disease (COPD), including emphysema and chronic
bronchitisCOPD Cystic fibrosis (thick mucus in the lungs and
respiratory tract) Lung abscess Lung cancer Pulmonary fibrosis
(scarring of the lungs)
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s
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Gastrointestinal disease causes of finger clubbing Finger
clubbing can also be caused by gastrointestinal diseases including:
Celiac diseaseCeliac disease (severe sensitivity to gluten from
wheat and other grains that causes intestinal damage)
CirrhosisCirrhosis of the liver Inflammatory bowel
diseaseInflammatory bowel disease (includes Crohns disease and
ulcerative colitis)ulcerative colitis Liver cancer.
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Other causes of finger clubbing Finger clubbing can also have
other causes including: Dysentery (infectious inflammation of the
colon, causing severe diarrhea)diarrhea Graves disease (type of
hyperthyroidism resulting in excessive thyroid hormone production)
Hodgkins lymphoma (cancer of the lymph tissues)
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Cardiac murmurs
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1-Innocent : A:Stills murmur---> the most common B:Pulmonic
flow murmur of infancy C:Pulmonic flow murmur of childhood D:Venous
hum
Acyanotic Nl pulmonic flow disease: All type of obstructive or
regurgitant inflow or outflow tracts. Acyanotic high pulmonic flow
disease: ASD,Gerbods defect,VSD,PDA, Aorto-pulmonary
window,PAPVC
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Atrial Septal Defect
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Septal defects: Inter atrial communication : Secundum ASD(the
most common type) Primum ASD(is associated with MV cleft) Sinus
venosous defect (SVC type ASD) Coronary sinus defect IVC type ASD
Common atrium
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According to Fossa Ovalis: PFO or ASD2 ASD1(Ant) Sinus venosous
defect(Ant &Sup) Coronary sinus defect(Ant &Inf) IVC type
ASD (Post & Inf ) Common atrium (near or total absence of inter
atrial septum)
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Anatomic closure of foramen oval in the first year of life. No
closure: 25-30% PFO : < or = 3.5mm Small ASD2 : 3.5-5mm Mod :
5-8mm Large : > 8mm
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Overally the clinical manifestations of ASDs depend on
magnitude of intracardiac shunt.
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Most infants with ASDs are asymptomatic, and the condition goes
undetected. They may present at 6 to 8 weeks of age with a soft
systolic ejection murmur and possibly a fixed and widely split S 2.
Older children with a moderate left-to-right shunt often are
asymptomatic.
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Children with large left-to-right shunts are likely to complain
of some fatigue and dyspnea. Growth failure is very uncommon.
Rarely, ASDs in infants are associated with poor growth, recurrent
lower respiratory tract infection, and heart failure.
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Kalifornia- Fire waterfall
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Congestive heart failure rarely is found in the first decades
of life, but it can become common once the patient is older than 40
years of age. The onset of atrial fibrillation or, less commonly,
atrial flutter can be a hallmark in the course of patients with
ASDs. The incidence of atrial arrhythmias increases with advancing
age to as high as 13% in patients older than 40 years of age and
52% in those older than 60 years of age.
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Pulmonary vascular disease can occur in 5% to 10% of patients
with untreated ASDs, predominantly in females. Usually it occurs
after 20 years of age, although rare cases in early childhood have
been recorded.
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ECG: RAD, RAE rsR in V1 (in complet RBBB)
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Outcome: Secundum ASDs can close spontaneously, remain open, or
enlarge. It appears that spontaneous closure, or a decrease in
size, is most likely to occur in ASDs
