Penyakit Jantung Pada Anak
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PENYAKIT JANTUNG BAWAAN PADA ANAK
Deteksi dini penyakit jantung pada anak
• Biru• Aktifitas kurang• Sesak• Batuk berulang• Berat badan tidak meningkat
Structures of the heart
Penyakit Jantung Bawaan• A. PJB Asianotik
– ASD– VSD– PDA
b. PJB Sianotik- TF- TGA
Normal Heart
Atrial Septal defect( ASD )
• Insidence : + 10 %• ♀: δ ratio = 2 : 1• Anatomy :
Defect on foramen ovale : Secundum ASD Defect at SVC and RA junction: sinus
venosus ASD Defect at ostium primum : primum ASD
RA
RV
LA
LV
RA
RV
LA
LV
Atrial septal Defect
Clinical findingsAsymptomaticAuscultation :
Normal 1st HS or loudWidely split and
fixed 2nd HSEjection systolic murmur
Atrial septal Defect
Atrial Septal defect
ManagementSurgery : Preschool ageRecent treatment: transcatheter closure using
ASO (Amplatzer septal occluder)
Ventricular septal defect• Insidence
20 % of all CHD No sex influence
RA
RV
RA LALA
RV LVLV
Ventricular septal defect
Ventricular Septal Defect
• Clinical findingsDay 1st after birth: murmur (-)After 2-6 weeks : murmur (+)Murmur : pansystolic grade 3/6 or higher
at LSB 3 Small muscular defect: early systolic murmurSignificant defect: Mid diastolic murmur at apex
Ventricular septal defect
Management:
Definitive : VSD closure Surgery Transcatheter closure
Patent Ductus Arteriosus Insidence
+ 10%Female : Male = 1.2 to 1.5 : 1Premature and LBW higher
AnatomyFetus: ductus arteriosus connects PA and aorta.
If ductus does not closs Patent Ductus arteriosus
RA
RV
LA
LV
RA LA
RV LV
Patent Ductus Arteriosus
Patent Ductus Arteriosus
• Clinical findings
Small defect: Symptom (-) Growth and development normal
Significant defect:Decreased exercise tolerantWeigh gained not goodFrequent URTI
Specific case: pulsus seler at 4th extremities
Tetralogy FallotInsidence5-8% from all CHD
Sindroma consist of 4 items: VSD pulmonary stenosis aortic over-riding RVH
Tetralogy Fallot
Hemodynamic acyanotic Hemodynamic cyanotic
Tetralogy Fallot
• Diagnosis
Clinically : cyanosis Single 2nd HS, ejection systolic murmur
CXR : Boot-shaped
Tetralogy Fallot
Transposition of Great Artery
Insidence5% of CHD
AnatomyAbnormality of formation of trunkal septum that cause aorta arising from RV and PA arising from LV
Transposition of Great artery
Hemodynamic normal Hemodynamic of TGA“series” “parallel”
Transposition of Great artery
TGA with large VSD TGA with VSD and PS
Transposition of Great artery
• Clinical aspects
More frequent in maleBirth weight usually normal normal or biggerCyanotic vary from mild to severeAuscultation : single 2nd HS and loudMurmur vary from silent to pansystolic murmur or continuous murmur
Transposition of Great artery
• DiagnosisClinically :
Suspicious if neonates presents with cyanotic with birth weight normal or bigger
Murmur (-)Single 2nd HS and loud
Transposition of Great artery
Transposition of Great artery
CXR :CardiomegalyEgg-on-side
heart