Download Summary of Roger`s Disease (aka Ventricular Septal Defect)

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Transcript
Summary of Roger’s Disease (aka Ventricular Septal Defect)
Presented by: Peter Shalvardjian, Henry Chen, and David Zhao
 A ventricular septal defect is a hole in the wall of the heart (septum) that separates
the left ventricle from the right ventricle
 Roger’s Disease is a CONGENTIAL HEART DISEASE (present at birth).
 Congenital heart defects are errors in the development of the heart structure.
 Larger Ventricular Septal Defects (VSDs) are more dangerous than smaller ones
 Larger VSDs, may result in a dangerous LEFT-TO-RIGHT SHUNT. The shunt
causes the right ventricle to receive more blood than usual. The more blood that is
diverted to the right side of the heart, the harder the lungs and right ventricle must
work to compensate for the problem.
PATHOPHYSIOLOGY:
 Eventually, the stress on the overworked right ventricle may cause it to weaken and/or enlarge.
 The lungs can also become congested from constantly receiving more blood than is needed.
 Eventually, the congestion and overwork can lead to ARRHYTHMIAS or even HEART
FAILULRE.
SIGNS AND SYMPTOMS:
 Proportional to the size of the defect
 Swelling in legs, abdomen or around the eyes.
 Children with this defect tire easily
 May result in stunted growth
 Bluish tint to the skin, lips, and fingernails (due to inadequate supply of O2)
 Rapid Heart Rate
 Children with VSD tend to suffer more frequent cold and pneumonia, and have a higher rate of
inflammation and infection of the heart (endocarditis).
DIAGNOSIS:
 First thing they do is listen with a stethoscope for a heart murmur.
 The presence of a heart murmur leads to other tests. Some of these include:
 Chest X-ray – looks at condition of heart (enlarged in VSD) and lungs
 ECG – test helps diagnose heart defects or rhythm problems
 Echocardiogram – uses sound waves to produce a video image of the heart. This
image allows doctors to see if your baby’s heart is abnormal and if it is pumping
properly
TREATMENT:
 Most small holes close without treatment. If the hole is large or fails to close, the child is usually treated with
DRUGS. Holes that persist and are causing problems in development are corrected by OPEN HEART SURGERY.
DRUG OPTIONS:
 Medications That Keep the Heartbeat Regular – ie. Beta-blockers and digoxin
 Medications that Increase the Strength of the Heart’s Contractions – ie. Digoxin
 Medications that Decrease the Amount of Fluid in the Circulation – reduces volume of
blood that must be pumped. These are called diuretics and include fursemide (Lasix)
SURGERY:
 Usually surgery is performed after one year of age (allows time for trial of drug therapy)
 Surgery for a VSD involves plugging or patching the abnormal opening between the ventricles. This usually
involves open-heart surgery, which is done under general anesthesia.
 The doctor uses patches or stitches to close the hole