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