congenital cardiac...

Congenital Cardiac Anomalies Cardiovascular Pathology

VPM 222

Winter 2009

Causes of Congenital Heart Anomalies

Genetic Single or multiple defects

Infectious agents Parvovirus

Bluetongue

BVD

Teratogens Vit A deficiency

Xrays

Oxygen deficits

Teratogenic compounds

Cardiovascular MalformationsBreeds and Species

Page 13 lecture notes

http://www.embryology.ch/images/pimgcardio/09umstellung/p9a_KreislaufvorA.gif

The Atrial Septum and its

Abnormalities

Foramen Ovale

Normal

Atrial Septal Defect

Common Atrium

Haemodynamics

L to R flow

Volume Right

CVP

Boxer, Doberman

pinscher, SamoyedPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th

ed

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 5 September 2005 08:31 PM)

Atrial Septal Defect

Pathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Abnormalities of the

atrioventricular

Canal

1. Persistent Common Atrioventricular Canal

Endocardial Cushion Defect

Failure of endocardial cushions to form

Often have ASD and VSD

Abnormalities of the AV Canal1. Endocardial Cushion

Defect

2. Tricuspid dysplasia

3. Mitral valve malformations

4. Tricuspid atresia

Abnormalities of the

INTERVENTRICULAR SEPTUM

Interventricular Septal

Defect (VSD)

Membranous

Muscular

overload RV RV

psi RVH RVF

Could reverse flowPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Membranous VSD

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

Membranous VSD

http://www.embryology.ch/anglais/pcardio/patholcardio03.html#AtrioventrikularerSeptumdefekt

Muscular VSD

Abnormalities of the truncus arteriosus and conus cordia

Tetralogy of FallotPulmonic Stenosis

Interventricular Septal Defect

Over-riding Aorta

Right Ventricular Hypertrophy

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

Haemodynamics of Tetralogy of Fallot

Pulmonic stenosis

RVH (psi overload)

VSD

Shunt R – L

Cyanosis

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

http://www.embryology.ch/anglais/pcardio/patholcardio04.html#Fallot

Abnormalities of the truncus

arteriosus and conus cordia

Tetralogy of Fallot

Eisenmenger’s Complex

Tetralogy of Fallot without Pulmonic

Stenosis

Eisenmenger’s Physiology/Syndrome

- Right to left shunt

Persistent Truncus ArteriosusFailure of spiral ridge to truncus arteriosus and conus cordis

No separation of pulmonary artery and aorta – common truncus

Transposition of Great Vessels

http://path.upmc.edu/cases/case58/dx.html

Pulmonic StenosisPulmonic Outflow Obstruction

Circumference of

pulmonic valve <

aorta valve

Haemodynamics

Psi overload

concentric right

ventricular

hypertrophy right

heart failurePathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th edHeart disease web site - general

information – U of Manitoba

Pulmonic Stenosis

Pulmonic Stenosis

Post stenotic dilation

Pathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Aortic StenosisValvular

*Subvalvular

Haemodynamics

Arrythmia

Cardiac syncope

psi of LV concentric

LVH LVF (10%)

Common Swine

Newfoundland, Boxer,

German shepherd

Positional AbnormalitiesEctopia Cordis

Great Vessels Abnormalities

Patent Ductus Arteriosus

Failure of ductus arteriosus to close by 3 weeks

Haemodynamics Blood shunts LR

From aorta to pulmonary artery

pulmonary circulation

workload on LHPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th

ed

Poodles, Collies, Pomeranians, Chihuahua, Maltese, etc

Persistent Right Aortic Arch

PRAA

Right 4th Aortic Arch

remains – left aortic

arch disappears

Vascular ring

anomaly Ascending aorta

Ligamentum arteriosum

Pulmonary artery

Base of heart

Persistent Right Aortic Arch

PRAA