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

RA
RV
LA
LV
RA
RV
LA
LV
Atrial septal Defect
Clinical findings
Asymptomatic
Auscultation :
Normal 1st HS or loud
Widely split and fixed
2
nd
HS
Ejection systolic murmur

Atrial septal Defect
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
RA
RV
RA
LA
LA
RV LV LV
Ventricular septal defect
Ventricular Septal Defect
Clinical findings
Day 1
st
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

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 tolerant
Weigh gained not good
Frequent URTI
Specific case: pulsus seler at 4
th
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 2
nd
HS, ejection systolic murmur

CXR :

Boot-shaped
Tetralogy Fallot
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
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 2
nd
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 2
nd
HS and loud

Transposition of Great artery
Transposition of Great artery
CXR :
Cardiomegaly
Egg-on-side
heart