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Congenital Heart Disease
Types of Congenital Heart Disease
The 22 different types of Congenital Heart Disease include:
1. Aortic Atresia, Ischemic Stroke: In this condition, the left ventricle has a very small opening or no opening into the aorta. The valve is unable to open properly resulting in non movement of blood from the ventricle to the body, thus the only source of blood to body would be ductus arteriosus. This condition is in association with another defect called hypoplastic left heart syndrome (HLHS) (2).
2. Aortic Stenosis: An aortic valve has three leaflets that function like a one-way door permitting the blood to flow into the aorta and not backward into the left ventricle. In this defect, the aortic valve does not open properly leading to only a partial flow of blood from the left ventricle to the aorta, thus blood flowing from the left ventricle to the aorta is constricted. Aortic Stenosis is alternately labeled different names, depending on the location of the constriction:
3. Atrial Septal Defect (ASD): A hole in the wall of the atrial septum, dividing the atria (the two upper chambers) of the heart, is known as an atrial septal defect. This defect causes mixing of oxygenated blood with deoxygenated blood leading to more blood flow to the lungs through the right ventricle. The ASD’s are further classified into three types depending on the area of defect:
4. Atrioventricular Septal Defect (AVSD): In this defect, the atria and ventricles are not separated into their respective chambers with mitral and tricuspid valves also not being separated resulting in a large hole between the two atria, the two ventricles and just a single atrioventricular valve is formed instead of separate mitral and tricuspid valves (5).
5. Bicuspid Aortic Valve: In this defect, two leaflets develop instead of the usual three leaflets in the left pumping chamber of the heart (6).
6. Coarctation of the Aorta or Aortic Coarctation: In this defect, the aorta narrows causing decreased blood flow to the lower part of body and high blood pressure in the arms (7).
7. Dextrocardia: In this defect the heart develops to the right side instead of left side, if the heart develops normally it would not pose any problems. It is important to note that organs such as the abdominal organs develop in the reverse position in people with dextrocardia (8).
8. Ebstein's Anomaly: The tricuspid valve in a normal heart is between the right atrium and the right ventricle but in this defect, it is in the right ventricle leading to a bigger right atrium due to stretching and a smaller right ventricle (9).
9. Hypoplastic Left Heart Syndrome (HLHS): In this defect, the left side of heart is underdeveloped and a hole in the atria of the heart leads to leaking of oxygen rich blood into the right atrium (10).
10. Interrupted Aortic Arch: In this defect, the aorta is not properly developed leading to non-supply of oxygenated blood to various parts of the body; however, heart manages to supply blood through patent ductus arteriosus that remains open after birth (11).
11. Mitral Valve Prolapse: In this defect, one or both valves of the mitral valve bulge into the left atrium and may not shut tightly leading to leakage of blood from the left ventricle to the left atrium (a condition called mitral valve insufficiency or mitral regurgitation) requiring treatment depending on the severity of the condition (12).
12. Patent Ductus Arteriosus (PDA): The ductus arteriosus is a passage that permits oxygenated blood to a baby’s circulatory system through the placenta bypassing the lungs of baby. The ductus arteriosus closes after birth but if it remains open after birth, it is called a Paten Ductus Arteriosus. This defect leads to flow of oxygen rich blood from the aorta back through lungs resulting in more blood reaching the pulmonary vessels ultimately causing congestive heart failure (13).
16. Tetralogy of Fallot: This condition involves four defects that are primarily influenced by two major defects. A hole between the ventricles causes mixing of oxygenated blood with deoxygenated blood which provides the body with less oxygen than normal. A narrowed pulmonary valve prevents a normal volume of blood from getting into the pulmonary arteries and as a consequence the lungs receive less deoxygenated blood than normal. There may also be a thickened right ventricle wall and an aorta partially covering the ventricular septal defect (VSD, see #22) (17).
17. Total Anomalous Pulmonary Venous Return (TAPVR): In this condition, the oxygenated blood from the lungs is returned through the right atrium instead of the left atrium and this condition is usually accompanied with atrial septal defect (ASD) permitting the flow of blood from the right atrium to the left atrium. In the absence of ASD, this condition of TAPVR is fatal since there is no oxygen rich blood from the heart being circulated through the body (18).
18. Transposition of the Great Arteries (TGA): In this defect, positions of the vessels carrying blood to the lungs and the body are interchanged, meaning – the aorta originates from the right ventricle and the pulmonary artery comes out of the left ventricle thus oxygenated blood flows to the lungs and deoxygenated blood flows around the body. This defect is fatal unless accompanied with other defects such as atrial septal defect (ASD), a ventricular septal defect (VSD, see #22), or patent ductus arteriosus. There are two types of TGA which include:
19. Tricuspid Atresia: In this serious but rare condition, there is no blood flow from the right atrium to the right ventricle due to non-development of the tricuspid valve and thus the right ventricle is also not fully formed. An atrial septal defect (ASD) and ventricular septal defect (VSD, see #22) are usually present enabling blood to reach the pulmonary artery and lungs (20).
20. Truncus Arteriosus: In this defect, a big artery is present on top of the left and right ventricles along with a ventricular septal defect (VSD, see #22) causing a mixing of oxygenated blood with deoxygenated blood. This defect leads to excess blood flow to the lungs and very little blood flow to the body (21).
21. Vascular Ring: An abnormal development of the aortic arch forms a vascular ring that develops, surrounds and squeezes structures such as the trachea or windpipe causing respiratory or feeding problems (22).
22. Ventricular Septal Defect (VSD): An opening or a hole in the ventricular septum is known as a ventricular septal defect. This opening, or a hole, causes mixing of oxygenated blood from the left side of the heart with deoxygenated blood on the right side, compelling the heart to overwork and consequently makes it larger (23).
Article by Kona Vishnu, MS
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