KRISNATALIGAN

KARDIOLOGI ANAK
Topik
1. Fisiologi peredaran darah pada janin
2. PJB non sianotik
a) Defek Septum Atrium
b) Defek Septum Ventrikel
c) Defek Septum Atrioventrikuler
d) Duktus Arteriosus Paten
3. PJB sianotik
a) Trunkus arteriosus
b) Anomali Total Drainase Vena Pulmonalis
c) Ventrikel Tunggal

1. Fisiologi Peredaran Darah Pada Janin

2a. Defek Septum Atrium
Atrial septal defect (a) The ostium secundum atrial
septal defect (ASD) is a deficiency of the foramen
ovale and surrounding atrial septum. (b) Partial
atrioventricular septal defect (AVSD) is a deficiency
of the atrioventricular septum. (c) Murmur. (d)
Chest radiograph. (e,f) ECG. (g) Examples of an
occlusion device used to close secundum atrial
septal defects.
2b. Defek Septum Ventrikel
Dibagi : Ostium Primum, Ostium
Secundum
Ventricular septal defect. (a) Ventricular
septal defect showing a left-to-right
shunt. (b) Murmur. (c) Chest radiograph.
(d) ECG.
2c. Defek Septum Atrioventrikuler
Features of complete Atrioventricular
Septal Defect are:
Presentation on antenatal ultrasound
screening
Cyanosis at birth or heart failure at 23
weeks of life
No murmur heard, the lesion being
detected on routine echocardiography
screening in a newborn baby with Down
syndrome
There is always a superior axis on the ECG
Management is to treat heart failure
medically (as for large VSD) and surgical
repair at 36 months of age.
2d. Duktus Arteriosus Paten
Persistent ductus arteriosus. (a) Murmur. (b) Chest
radiograph. (c) ECG. (d) A persistent ductus arteriosus
visualised on angiography. (e) A coil used to close ducts. It is
passed through a catheter via the femoral artery or vein. (f)
Angiogram to show coil in the duct. (PT, pulmonary trunk;
AO, aorta.)
3a. Trunkus Arteriosus
Clinical Presentation :
Blue coloring of the skin
(cyanosis)
Poor feeding
Excessive sleepiness
Poor growth
Shortness of breath (dyspnea)
Rapid breathing (tachypnea)
Irregular heartbeats
(arrhythmia)
Excessive sweating
(diaphoresis)
3b. Anomali Total Drainase Vena
Pulmonalis
Exams and Tests :
Cardiac catheterization can
confirm the diagnosis by
showing that the blood vessels
are abnormally attached
ECG shows enlargement of the
ventricles (ventricular
hypertrophy)
Echocardiogram may show that
the pulmonary vessels are
attached
MRI of the heart can show the
connections between the
pulmonary vessels
X-ray of the chest shows a
normal to small heart with fluid
in the lungs
3c. Ventrikel Tunggal
Foto toraks menunjukkan konfigurasi jantung yang
tidak khas. Atrium kanan membesar dan vaskularisasi
paru meningkat (kecuali terdapat stenosis pulmonal).
Elektrokardiogram menunjukkan aksis deviasi ke
kanan atau ke kiri. Bila terdapat stenosis pulmonal
maka terlihat adanya P pulmonal.
Ekokardiografi akan menunjukkan adanya satu
ventrikel yang besar dengan 2 katup artrio ventrikular
tanpa septum ventrikel.