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CONGESTIVE HEART FAILURE ET CAUSA PATENT DUCTUS ARTERIOSUSPresented by :1.Gheavita Chandra Dewi (100100045)2.Kevin Dilian Suanda(1001000!5)Su"ervis#rdr. $a%id Di&yati' S"((K))ntr#du*ti#n+eart ,ailure (+-) #**urs when the heart *ann#t deliver ade.uate *ardia* #ut"ut t# &eet the &etab#li* needs #, the b#dy/hen a *hild is ad&itted t# the h#s"ital ,#r heart ,ailure' the *#sts are *#nsiderably hiher ,#r *hildren than adults be*ause #, the ,re.uent need ,#r suri*al #r *atheter0based interventi#n. +eart -ailure1he *urrent (&eri*an C#llee #, Cardi#l#y ((CC)2 (&eri*an +eart (ss#*iati#n ((+() uidelines de3ne +- as a *#&"le4 *lini*al syndr#&e that *an result ,r#& any stru*tural #r ,un*ti#nal *ardia* dis#rder that i&"airs the ability #, the ventri*le t# 3ll with #r e5e*t bl##d6"ide&i#l#y1he larest study' usin 2 lare data0bases en*#&"assin 507 #, 8S "ediatri* (ae 19 years) h#s"ital dis*hares' identi3ed 5:10 *hildren in a sinle year'C#nenital heart disease #r *ardia* surery a**#unted ,#r :17 #, *ases' and ,#r ;27 #, *ases #, heart ,ailure in in,antss' sh#rtness #, breath is n#t related t# the the weather and a*tivity. Sh#rtness #, breath be*#&es heavier when the "atient have an ins"irati#n. Sh#rtness #, breath is relieved when his "arents "ut #ne #r tw# "ill#w bel#w his head. 1he "atient #,ten wa>e u" in the &iddle #, the niht be*ause #, his sh#rtness #, breath.C#uh (C)' e4"erien*ed by the "atient sin*e the ae #, 1 nth and it be*#&e heavier in this #ne wee>. C#uh with s"utu& (C) and itDs di@*ult t# reve.)nterru"ted ,eedin hist#ry (C)' hist#ry ,#rehead sweatin while ,eedin (C) in these 2 nths. +ist#ry #, blue was n#t ,#und+ist#ry #, ,ever (C)' e4"erien*ed by the "atient in #ne wee>',ever is n# t## hih (sub,ebris)' s#&eti&es the ,ever is #ne and s#&eti&es it *#&es ba*> aain' the ,ever is de*reased by anti"yreti* &edi*ine. A#w the "atient d#esnDt have any ,ever.Patients were re,errals ,r#& the eneral h#s"ital #, Sari ?utiara by "ediatri*s s"e*ialist d#*t#r with dian#sis #, C+- e* PD( with Br#n*h#"neuniaPara*etal' -ur#se&id' S"ir#n#la>t#nHistor o! "re#ious i$$ness Histor o! dru%s+e is third *hild' ae #, the ther when "renant "atients is 2! years #ld' &aternal hist#ry #,,ever (0)' diabetes (0)' hy"ertensi#n (0)' ta>in birth *#ntr#l "ills (0)'drin>in herbs (0) and drus (0).S"#ntane#usE ater&E attended by &idwivesE *ryin (C)E hist#ry #, blue (0)E B/F000 ra&E BG 49 *&' reenish *#l#r #, a&ni#ti* HuidPre%nant Histor &irt' HistorBCG' +e"atitis B' DP1' P#li# Ia**ines were *#&"lete-r#& birth t# 1 nth : Breast &il> -r#& 1 nth t# 4 nths: Breast &il> with ,#r&ula &il>-r#& 4 nths until n#w: -#r&ula &il>I((uni)ation HistorFeedin% HistorC#ns*i#usness: C#&"#s &entis' Bl##d "ressure 1102!0 &&+ (A: ;001002 500;0)' +' b#dy lenth: 55*&.(ne&i* (C)' )*teri* (0)' Cyan#sis (0)' 6de&a (0)' Dys"nea (0). Head: 6ye: )is#*h#ri* "u"il (F&&2F&&)' liht reHe4 (C2C)' in,eri#r "al"ebra*#n5un*tiva "ale (C2C)' i*teri* s*lera (020).A#se' ?#uth and 6ar were within n#r&al li&it Neck:1IJ di@*ult in value' Gy&"h n#de enlare&ent (0).Presens status Loca$i)ed status Thorax: Sy&&etri*al ,usi,#r&is' Chest retra*ti#n (C)' +< : 1:5 b"&' reuler' &ur&ur (C)*#ntinu#us &ur&ur rade F2: at )C< ))0))) linea "arasternal de>stra' radiati#n (C) until le,t l#wer sternal b#rder'