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Pathology - Congenital Heart Disease
Ventricular septal defect
• The predominant form of congenital heart disease (CHD). • An atypical perforation in the interventricular septum. • May manifest anywhere inside the septum, albeit the majority are located in the superior region. A minor ventricular septal defect (VSD) may possess minimal functional significance and may close spontaneously as the infant matures. Nonetheless, there persists a risk of infective endocarditis. A significant VSD results in a left-to-right shunt, leading to augmented volume overload on the right ventricle, accompanied with manifestations of heart failure.
Patent ductus arteriosus
• Continuation of the ductus arteriosus beyond 10 days of life. • Systemic blood flows from the aorta to the pulmonary artery, resulting in a left-to-right shunt. Blood flow to the lungs is augmented twofold, as is the amount returning to the left side of the heart, resulting in left ventricular hypertrophy. • Infective endocarditis is a common complication.
Atrial septal defect
• An atypical orifice in the atrial septum. The most prevalent location is the central region of the septum, distant from the atrioventricular valves. • Blood circulates from the left atrium to the right atrium, resulting in enhanced pulmonary circulation. • May be asymptomatic or lead to increased fatigue during childhood. • Many individuals appear in maturity due to atrial arrhythmias.
Atrioventricular septal defect
• A defect at the intersection of the atrial and ventricular septa. • In a complete atrioventricular septal defect (AVSD), there exists a combination of a low atrial septal defect (ASD) and a high ventricular septal defect (VSD), effectively creating a central orifice in the heart. • Most function similarly to a VSD, resulting in volume overload to the right ventricle. • The most prevalent form of congenital heart disease (CHD) observed in children with Down syndrome.
Tetralogy of Fallot
• Includes pulmonary stenosis, ventricular septal defect (VSD), overriding aorta, and right ventricular hypertrophy. • Pulmonary stenosis induces a right-to-left shunt and diminishes pulmonary blood flow, leading to cyanosis. Transposition of the major arteries • Misplacement of the aorta to the right ventricle and the pulmonary artery to the left ventricle. • Typically accompanied with a defect that facilitates the mixing of blood from both circulations (e.g., ventricular septal defect [VSD] or patent ductus arteriosus [PDA]), otherwise the anomaly is incompatible with survival.
Coarctation of the aorta
• A localized constriction of the aortic arch lumen distal to the left subclavian artery's origin. • In the infantile variant, a patent ductus arteriosus distal to the coarctation facilitates cardiac output to the lower body; however, this predominantly consists of deoxygenated blood from the right heart, resulting in cyanosis of the lower body.
• In the adult variant, a patent ductus arteriosus is absent.
Enhanced blood flow to the upper body results in the majority of individuals experiencing upper extremity hypertension. This kind is frequently unacknowledged until adulthood. Bicuspid aortic valves typically function adequately at birth and sometimes remain undiagnosed. Most bicuspid valves ultimately progress to calcific aortic stenosis, occurring at an earlier age than the usual senile aortic stenosis, or aortic regurgitation. • Elevated risk of aortic dissection in adulthood
Ventricular septal defect
• The predominant form of congenital heart disease (CHD). • An atypical perforation in the interventricular septum. • May manifest anywhere inside the septum, albeit the majority are located in the superior region. A minor ventricular septal defect (VSD) may possess minimal functional significance and may close spontaneously as the infant matures. Nonetheless, there persists a risk of infective endocarditis. A significant VSD results in a left-to-right shunt, leading to augmented volume overload on the right ventricle, accompanied with manifestations of heart failure.
Patent ductus arteriosus
• Continuation of the ductus arteriosus beyond 10 days of life. • Systemic blood flows from the aorta to the pulmonary artery, resulting in a left-to-right shunt. Blood flow to the lungs is augmented twofold, as is the amount returning to the left side of the heart, resulting in left ventricular hypertrophy. • Infective endocarditis is a common complication.
Atrial septal defect
• An atypical orifice in the atrial septum. The most prevalent location is the central region of the septum, distant from the atrioventricular valves. • Blood circulates from the left atrium to the right atrium, resulting in enhanced pulmonary circulation. • May be asymptomatic or lead to increased fatigue during childhood. • Many individuals appear in maturity due to atrial arrhythmias.
Atrioventricular septal defect
• A defect at the intersection of the atrial and ventricular septa. • In a complete atrioventricular septal defect (AVSD), there exists a combination of a low atrial septal defect (ASD) and a high ventricular septal defect (VSD), effectively creating a central orifice in the heart. • Most function similarly to a VSD, resulting in volume overload to the right ventricle. • The most prevalent form of congenital heart disease (CHD) observed in children with Down syndrome.
Tetralogy of Fallot
• Includes pulmonary stenosis, ventricular septal defect (VSD), overriding aorta, and right ventricular hypertrophy. • Pulmonary stenosis induces a right-to-left shunt and diminishes pulmonary blood flow, leading to cyanosis. Transposition of the major arteries • Misplacement of the aorta to the right ventricle and the pulmonary artery to the left ventricle. • Typically accompanied with a defect that facilitates the mixing of blood from both circulations (e.g., ventricular septal defect [VSD] or patent ductus arteriosus [PDA]), otherwise the anomaly is incompatible with survival.
Coarctation of the aorta
• A localized constriction of the aortic arch lumen distal to the left subclavian artery's origin. • In the infantile variant, a patent ductus arteriosus distal to the coarctation facilitates cardiac output to the lower body; however, this predominantly consists of deoxygenated blood from the right heart, resulting in cyanosis of the lower body.
• In the adult variant, a patent ductus arteriosus is absent.
Enhanced blood flow to the upper body results in the majority of individuals experiencing upper extremity hypertension. This kind is frequently unacknowledged until adulthood. Bicuspid aortic valves typically function adequately at birth and sometimes remain undiagnosed. Most bicuspid valves ultimately progress to calcific aortic stenosis, occurring at an earlier age than the usual senile aortic stenosis, or aortic regurgitation. • Elevated risk of aortic dissection in adulthood
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