Hemiparesis Congenital Heart Disease Congenital heart disease CHD is the most common type of birth defect CHD refers to a problem with the hearts structure that occurred because of abnormal development in the heart before birth CHD consists of 2 categories Cyanotic CHD and ID: 503623
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Slide1
Congenital Heart Disease &
Hemiparesis
Slide2
Congenital Heart Disease
Congenital heart disease (CHD) is the most common type of birth defect. CHD refers to a problem with the heart’s structure that occurred because of abnormal development in the heart before birth. CHD consists of 2 categories: Cyanotic CHD and
Acyanotic
CHD. CHD is a risk factor for emboli development which can contribute to
cerebrovascular
accidents. Slide3
Occurrence & Risk Factors
Most cases of CHD occur in isolation
CHD can be associated with various genetic disorders such as Down Syndrome,
Marfan
Syndrome, Turner Syndrome and
Trisomy
13
Risk factors:
Associated with maternal intake of
retonic
acid (for acne), alcohol, chemical exposure
and rubellaSlide4
Acyanotic
CHD
Presentation
Pink in coloring
Normal oxygenation saturation
Involves left-to-right shunting so that oxygen rich blood is shunted to the lungs unnecessarily
Defects associated with
acyanotic
CHD
Atrial
septal
defect
Ventricular
septal
defect
Patent
ductus
arteriosus
Aortic
coarctation
Pulmonary
stenosis
Aortic
stenosis
Slide5
Cyanotic CHD
Presentation
Cyanosis (blue) in coloring
Oxygen saturation is 15 to 30% below normal
Involves right-to-left shunting so that
unoxygenated
blood is shunted to the body
Defects associated with CCHD
Tetralogy
of
Fallot
(TOF)
Transposition of the Great Artery
Tricuspid
Atresia
Pulmonary
atresia
Truncus
Arteriosus
Total Anomalous Pulmonary Venous Return
Hypoplastic
Left-Sided Heart SyndromeSlide6
Hemiparesis
and CHD
In study of children with brain abscesses, one pre-disposing factor was
unoperated
CCHD. This group of children with CCHD tended to have more significant cerebral complications (mid-line shift and cerebral edema) following drainage of the abscess. Other complications included
hemiparesis
and seizures for this group. Slide7
Cerebrovascular
Accidents and CHD
1/5 to 1/3 of ischemic childhood strokes can be attributed to underlying congenital heart defects
Due to paradoxical cerebral
emoblism
: emboli from the systemic venous circulation passes to arterial circulation from large
septal
defects, single ventricle, total anomalous pulmonary venous return,
truncus
arteriosus
Single ventricle physiology with right-to-left shunting is especially vulnerable to systemic emboliSlide8
References
Kirton
A,
DeVeber
G. Ischemic stroke complicating pediatric cardiovascular
disease. Nat
Clin
Pract
Cardiovasc
Med. 2007 Mar;4(3):163-6
.
Mehnaz
A,
Syed
AU,
Saleem
AS, Khalid CN. Clinical features and outcome
ofcerebral
abscess in congenital heart disease. J
Ayub
Med
Coll
Abbottabad
.
2006 Apr-Jun;18(2
):21-4.
Salih
MA, Al-
Jarallah
AS, Abdel-
Gader
AG, Al-
Jarallah
AA, Al-
Saadi
MM,
Kentab
AY
,
Alorainy
IA, Hassan HH. Cardiac diseases as a risk factor for stroke in
Saudi children
. Saudi Med J. 2006 Mar;27
Suppl
1:S61-8.
Wu YW, Lynch JK, Nelson KB.
Perinatal
arterial stroke:
understanding mechanisms
and outcomes.
Semin
Neurol. 2005 Dec;25(4):424-34. Review
.