This is a wide scope of a collection of congenital heart diseases whereby all blood returning to the right part of the heart transports through the Lungs and Pulmonary Vasculature normally. This problem is always present before or just immediately after birth hence, causing disorders and discomfort for the newly born infants.Patent Ductus Arteriosus
The direction of flow through a large patent ductus arteriosus (PDA) depends on the relative resistances in the pulmonary and systemic circuits. During physical examination, you will discover a continuous murmur which begins after S1, peaks with S2 and trails off in diastole.
Coarctation Syndrome
As the ductus arteriosus constricts in the neonatal period, obstruction increases at the coarctation site, leading to increased left ventricular afterload with subsequent left ventricular dysfunction, pulmonary hypertension and congestion heart failure.
In clinical manifestation, coarctation syndrome develops during the first year if infant's Life with irritability, lethargy, poor feeding and inadequate growth. Physical examination includes ashen color of skin, its mottling, decreased or absent lower extremity pulse, gallop rhythm, single loud S2, a nonspecific and often low-pitced systolic murmur and hepatomegaly.
Atrial septal defect (ASD)
The clinical manifestation of this syndrome is slow weight gain and frequent lower respiratory infections. In physical examination, right ventricular heave is present. A systolic ejection murmur in the pulmonic area and a mid-diastolic rumble murmur in the lower right sternal area reflect the increased flow across the pulmonary and tricuspid valves. S2 is widely and constantly split.
Ventricular septal defect (VSD)
VSD may be single or multiple and may be found anywhere along the septum, it is most common in the membranomuscular portion. As long as pulmonary vascular resistance is lower than systemic resistance, the shunt is left-to-right. If pulmonary vascular resistance rises above systemic resistance, the shunt reverses. The main clinical features are growth failure, congestive heart failure, shortness of breath, chest pain and cyanosis.
In physical examination, a left-to-right shunt produces turbulence during isovolumic contraction and the murmur begins with S1. The murmur usually is harsh and is best heard at the midsternal or lower left sternal border. It ends in mid-diastole in case of small defects and extends to the S2 in large left-to-right shunts.
Acquired Heart disease
Acquired heart disease, as opposed to congenital heart disease occurs as a result of a previously existing disease, defect or as a complication of an acute disease. The most common condition classified as acquired heart disease is congestive heart failure, usually as a complication of congenital heart disease, Cor Pulmonaie is the term applied to congestive failure that results from pulmonary hypertension associated with chronic lung disease, principally cystic fibrosis.
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