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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 %
: 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
Atrial septal Defect

RA LA

RA LA

RV LV
RV LV
Atrial septal Defect

Clinical findings
Asymptomatic
Auscultation :
Normal 1st HS or loud
Widely split and fixed
2nd HS
Ejection systolic murmur
Atrial Septal defect

Management
Surgery : Preschool age
Recent treatment: transcatheter closure using
ASO (Amplatzer septal occluder)
Ventricular septal defect
Insidence
20 % of all CHD
No sex influence
Ventricular septal defect

RA
LA
RA LA

RV LV RV LV
Ventricular Septal Defect

Clinical findings
Day 1st after birth: murmur (-)
After 2-6 weeks : murmur (+)
Murmur : pansystolic grade 3/6 or higher
at LSB 3
Small muscular defect: early systolic murmur
Significant 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 : 1
Premature and LBW higher

Anatomy
Fetus: ductus arteriosus connects PA and aorta.
If ductus does not closs Patent Ductus arteriosus
Patent Ductus Arteriosus

RA LA
RA LA

RV LV
RV LV
Patent Ductus Arteriosus

Clinical findings

Small defect:
Symptom (-)
Growth and development normal
Significant defect:
Decreased exercise tolerant
Weigh gained not good
Frequent URTI
Specific case: pulsus seler at 4th extremities
Tetralogy Fallot
Insidence
5-8% 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
Tetralogy Fallot
CXR :

Boot-shaped
Transposition of Great
Artery
Insidence
5% of CHD

Anatomy
Abnormality of formation of trunkal septum that cause
aorta arising from RV and PA arising from LV
Transposition of Great artery
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 male


Birth weight usually normal normal or bigger
Cyanotic vary from mild to severe
Auscultation : single 2nd HS and loud
Murmur vary from silent to pansystolic murmur or
continuous murmur
Transposition of Great artery

Diagnosis
Clinically :
Suspicious if neonates presents with cyanotic
with birth weight normal or bigger
Murmur (-)
Single 2nd HS and loud
Transposition of Great artery

CXR :
Cardiomegaly
Egg-on-side
heart