This congenital heart defect is in fact an opening in the upper part of the interventricular septum was due to nonunion of the aortic septum. In this way, the blood passes from the left ventricle where the high right ventricular pressure where pressure is low. In cases 1/4-1/3 shunt is not large enough to lead to strain rate. In the case of a large shunt leads to stress and the right and left ventricles.
The clinical picture
A. Symptoms and signs: clinical presentation depends on the diameter of the defect and the presence or odsustvapovećane pulmonary vascular resistance. If the defect is small levodesni shunt is small, if the defect of resistance to the flow of blood between the two ventricles is small and the large levodesnišant, increased pulmonary shunt levodesni vaskularnarezistencija decreases and turns pansistolični noise sided šum.U 3ćem 4tom and intercostals space dužsternuma heard long, loud and coarse systolic murmur and a faucet tril. This may not be the only finding small defects. In the case of large shunts at the top of the faucet heart podizanjedesnog ventricular diastolic and mean hear "flow noise" and can be heard in the third tone.
B. Radiographic findings in large šantovadesni or left ventricular or both, as the left atrium and pulmonary arteries were enlarged, and the pulmonary flow increased.
C. ECG: may be normal or may dapokazuje hypertrophy of the right, left or obaventrikla.
D. Special tests: kateterizacijomsrca possible to diagnose even unajkomplikovanijiiin cases. The children sadekompenzacijom heart is necessary to establish a diagnosis and advise appropriate treatment.
Treatment
Ventricular septum defect can be asymptomatic with normal hemodynamics of the heart. However, the children can be a serious flaw that results in death due to cardiac decompensation. These patients should undergo surgery. Ideal case in surgery with the use of the machine for extracorporeal circulation is the one with the big levodesnim Santo, left ventricular hypertrophy, and only moderate pulmonary hypertension. When it comes expressed pulmonary hypertension (pulmonary artery pressure> 85 mm Hg), and levodesni shunt is small, then the risk of surgery is at least 50%. Surgical intervention is contraindicated if the shunt Reverse. However, if a surgical intervention is necessary in such case.cardiac decompensation caused by large levodesnim SANTO recommends placing a ring around the pulmonary artery, which will reduce shunt. Only the children of 5-6 years of age it is necessary to make a definitive correction. Based on the growing experience led to the conclusion that some defects closed spontaneously (perhaps 30 - 50%). Therefore, surgery should be delayed until late childhood, except in cases where the inability to live very strong or when it is concluded that pulmonary hypertension increases.
Forecast
Patients with typical forest can expect a normal life, except that you can always develop bacterial endocarditis in patients. With large shunts in early childhood caused congestive heart and they rarely survive 40 years of age. Reverse shunt encountered in about 25% of cases, leading to Eisenmengerovog syndrome.
The clinical picture
A. Symptoms and signs: clinical presentation depends on the diameter of the defect and the presence or odsustvapovećane pulmonary vascular resistance. If the defect is small levodesni shunt is small, if the defect of resistance to the flow of blood between the two ventricles is small and the large levodesnišant, increased pulmonary shunt levodesni vaskularnarezistencija decreases and turns pansistolični noise sided šum.U 3ćem 4tom and intercostals space dužsternuma heard long, loud and coarse systolic murmur and a faucet tril. This may not be the only finding small defects. In the case of large shunts at the top of the faucet heart podizanjedesnog ventricular diastolic and mean hear "flow noise" and can be heard in the third tone.
B. Radiographic findings in large šantovadesni or left ventricular or both, as the left atrium and pulmonary arteries were enlarged, and the pulmonary flow increased.
C. ECG: may be normal or may dapokazuje hypertrophy of the right, left or obaventrikla.
D. Special tests: kateterizacijomsrca possible to diagnose even unajkomplikovanijiiin cases. The children sadekompenzacijom heart is necessary to establish a diagnosis and advise appropriate treatment.
Treatment
Ventricular septum defect can be asymptomatic with normal hemodynamics of the heart. However, the children can be a serious flaw that results in death due to cardiac decompensation. These patients should undergo surgery. Ideal case in surgery with the use of the machine for extracorporeal circulation is the one with the big levodesnim Santo, left ventricular hypertrophy, and only moderate pulmonary hypertension. When it comes expressed pulmonary hypertension (pulmonary artery pressure> 85 mm Hg), and levodesni shunt is small, then the risk of surgery is at least 50%. Surgical intervention is contraindicated if the shunt Reverse. However, if a surgical intervention is necessary in such case.cardiac decompensation caused by large levodesnim SANTO recommends placing a ring around the pulmonary artery, which will reduce shunt. Only the children of 5-6 years of age it is necessary to make a definitive correction. Based on the growing experience led to the conclusion that some defects closed spontaneously (perhaps 30 - 50%). Therefore, surgery should be delayed until late childhood, except in cases where the inability to live very strong or when it is concluded that pulmonary hypertension increases.
Forecast
Patients with typical forest can expect a normal life, except that you can always develop bacterial endocarditis in patients. With large shunts in early childhood caused congestive heart and they rarely survive 40 years of age. Reverse shunt encountered in about 25% of cases, leading to Eisenmengerovog syndrome.
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