VSD Sigrur Bra Fjalldal lknanemi Flokkar hjartagalla Non-cyanotic

VSD Sigrur Bra Fjalldal lknanemi Flokkar hjartagalla  Non-cyanotic

VSD Sigrur Bra Fjalldal lknanemi Flokkar hjartagalla Non-cyanotic

VSD 32 % PDA 12% Pulmonary stenosa 8% ASD 6% Aorta coarctation 6% Aorta stenosa 5% Cyanotic Tetralogy of Fallot 6%

Transposition stru unum 5% VSD 2-6/1000 32% allra mefddra hjartagalla rlti algengara hj stelpum 56% Fsturfri Skipting slegils tvennt verur 4-8 viku fsturroska Septum er upprunni r

Primitive interventricular septum Muscular septum Endocardial cushion sem vex niur vi a muscular septum Membranous septum verur til ar sem endocardial cushion mtist muscular septum-efri hluti skilur vinstri slegil fr hgri gtt ar sem mturlokan festist ofar septum mia vi tricuspidlokuna Fsturfri

Bulbar septum Rennur saman vi membranous og muscular septa vi crista supraventricularis Samruni membranous hluta ventricular septum, endocardial cushions og bulbus cordis (proximal hluta truncus arteriosus) Gerir VSD Membranous ventricular septal defect Algengasti defectinn 80% liggur beint fyrir nean

tricuspid lokuna. The bundle of His liggur posterior brn defectsins- heart block potential complication ager Supracristal defect Defect bulbar septum beint fyrir nean aortu loku og pulmonal loku 5-7%, srstaklega h tni Japan 30%. Hefur tengsl vi aortic cusp prolapse og artic regurgitation Gerir VSD

Muscular defect Er yfirleitt meftt en getur komi eftir trauma ea myocardial infarct, 5-20%, oft mrg op = swiss cheese septum Left ventricular/right atrial defect Defect membranous septum fyrir ofan tricuspid loku vinstri slegill opnast beint inn hgri gtt Pathophysiology

Functional truflunin sem verur hefur ekki svo miki a gera me stasetningu heldur rur str defects og hlutfallsegur rstingur lungna og systemblrsar mestu um hversu miki shunt verur Pathophysiology rstingur fellur sm saman lungnablrs-leyfir meira shunt-pulmonary overcirculation-pulmonary hypertensionauki avinm-hypertrophia hgri slegli sem me tmanum getur leitt til rightto-left shunt=Eisenmenger syndrome

Einkenni Ltill VSD me hum pulmonal rstingi leyfir lti shunt og er oft einkennalaus Fyrstu einkenni strri defectum geta veri tachypnea, tachycardia og barni erfiar vi ndun aukinn sympatskur tonus veldur aukinni svitamyndun reyta vi brjstagjf, mikilvgt a komi fram sgu hvernig nringin gangi endurteknar ndunarfraskingar cyanosa og clubbing

Skoun Precordial activity nr parasternalt hgra megin og yfir apex, krftugur samdrttur vinstra slegils Right ventricular overload=right ventricular heave Perifer plsar oft lflegir Pulmonal hypertension leiir til peripheral cyanosu og clubbing

Skoun Hjartahlj og thrill oft samfara Pansystolskt hlj sem heyrist best vi left lower sternal border, 3-4 rifjabil Radierar a right lower sternal border Skoun tstreymishlj um lungnaloku er yfirleitt yfirgnft af pansystlska hljinu Mtral dastolskt hlj vegna mikils flis um mtral loku bendir til a fli lungnablrs s

um tvfalt meira en system blrs. Splitting S2 meira berandi, pulmonal component hvrari strum defect me pulmonal hypertension Skoun Intensitet fer eftir str defects og rstings lungnablrs = smrri defect og minni rstingur gefur meira intensitet Mjg litlir defectar vva hlutanum heyrast oftast vi fyrstu skoun

strri defectum heyrist oft ekki fyrr en rstingur lungnablrs fellur og shunt eykst Rannsknir EKG vinstri ventricular hypertrophia stkkun vinstri gtt hgri ventricular hypertrophia/biventricular hypertrophia hj eldri brnum

Rntgen Hjartastkkun og aukin ateikn lungna mskoun me doppler oftast greinandi, greinir undirflokk og nkvma stasetningu septum Hjartaring Lokun ? Lokast oftast sjlfkrafa brnum yngri en 1

rs 30-50%. Er algengt a finnist hj brnum eldri en 2 ra Algengara a lokun veri muscular defect 80%, perimembranous defect lokast 3540% tilfella 30-50 % lokast fyrir 1 rs aldur Mefer langflestum tilfellum 80% er bei me ager til a sj hvort gati minnki ea lokist af sjlfu sr: Ltill og einkennalaus VSD Ef komi er veg fyrir hjartabilun me gu eftirliti og lyfjum.

Barni vex og dafnar sem skyldi og komi er veg fyrir lungnahrsting agrsilyf notu stundum bland vi ACE blokka. Digoxin minna nota en ur fyrr Ager yfirleitt ger um 6-12 mn aldur ef merki um hjartabilun ea hjartastkkun huga a gefa prophylaxa gegn bacterial endocardit ef defect lokast ekki a fullu. Mefer

Strir defectar mehndlair geta enda me hjartabilun 6-8 vikum Frri en 10% urfa a fara ager Langflestir losna algjrlega vi shunt eftir ager en right bundle branch blokk er ekki algeng eftir ager sem gefur berandi splitting ekki fixed

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