Reading Time:

Pathology

The most common cyanotic congenital heart disease consisting of:
1) Ventricular septal defect 
2) Pulmonary stenosis 
3) Overriding aorta  
4) Right ventricular hypertrophy 

Aetiology

Associated with DiGeorge Syndrome

Signs

Cyanosis in the first few days of life as the ductus arteriosus closes,
Ejection systolic murmur associated with pulmonary stenosis, squatting  
improves cyanosis, clubbing, polycythaemia, hypoxia, right ventricular heave 
and harsh S2 heart sound.

Symptoms

Failure to thrive

Investigations

ECG: Right axis deviation, right ventricular hypertrophy and right bundle branch 
block 
Chest X-Ray: Boot-shaped heart and decreased pulmonary vasculature 
Echo: To assess for structural abnormality and confirm diagnosis

Treatment

Hypercyanotic spells: Place in knee-chest position, administer oxygen, 
morphine and propanolol 
Surgical: Blalock-Taussig shunt to increased pulmonary blood flow, when 
infants are symptomatic with cyanosis.

Prognosis

Patients generally remain asymptomatic post surgical correction and have a
normal life expectancy
Arrhythmias, pulmonary regurgitation, heart failure and infective endocarditis.

Key Facts

Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.

Key Images

Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.

Key References

Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.