Prepared by:Dr. Majid Al-homiedan

Most common congenital cardiac lesion. The magnitude of the shunt depends on the size of the defect, the relative compliance of the ventricles, and the difference in atrial pressure. May be combined with mitral stenosis (Lutembacher's syndrome) and cause a substantial increase in the workload of the right ventricle.

Increased pulmonary vascularity; enlarged right atrium, right ventricle, and pulmonary outflow tract; normal left atrium and left ventricle; small aorta.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Common congenital cardiac anomaly. The magnitude of the shunt depends on the size of the defect and the difference in ventricular pressure. There may also be a shunt from the left ventricle to the right atrium.

Increased pulmonary vascularity; enlarged right ventricle, pulmonary outflow tract, left atrium, and sometimes left ventricle (may be normal); normal right atrium; normal or small aorta.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Ductus extends from the bifurcation of the pulmonary artery to join the aorta just distal to the left subclavian artery (shunts blood from the pulmonary artery into the systemic circulation during intrauterine life). The aortic end of the ductus (infundibulum) is often dilated to produce a convex bulge on the left border of the aorta just below the knob.

Increased pulmonary vascularity; enlargement of the left atrium, left ventricle, aorta, and pulmonary outflow tract; normal right atrium; enlarged or normal right ventricle.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Low atrial septal defect combined with a high ventricular septal defect. Most often occurs in children with Down's syndrome.

Increased pulmonary vascularity; nonspecific globular enlargement of the heart (enlargement of all cardiac chambers).

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Uncommon anomaly in which a communication between the pulmonary artery and the aorta (just above their valves) is caused by a failure of the primitive truncus arteriosus to separate completely.

Increased pulmonary vascularity; enlargement of the left ventricle, left atrium, and pulmonary outflow tract (similar to patent ductus arteriosus but usually a less prominent aortic knob).

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Rupture usually occurs into the right ventricle (occasionally the right atrium). Causes a sudden large left-to-right shunt with the acute onset of chest pain, shortness of breath, and a cardiac murmur.

Rapid increase in pulmonary vascularity and enlargement of the right ventricle and the pulmonary outflow tract.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

Unusual anomaly in which there is a communication between a coronary artery and a cardiac chamber or the pulmonary artery. The right coronary artery most often communicates with, in order of frequency, the right ventricle, right atrium, coronary sinus, or pulmonary artery.

Increased pulmonary vascularity; enlargement of the pulmonary outflow tract; enlargement of the right ventricle or both the right atrium and the right ventricle (depending on the site of the fistula).

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW

One (or more) of the pulmonary veins is connected to the right atrium or its tributaries. Virtually indistinguishable from an atrial septal defect radiographically. A scimitar sign (crescent-like anomalous venous channel) on the right if associated with hypoplasia of the right lung.

Increased pulmonary vascularity; enlarged right atrium, right ventricle, and pulmonary outflow tract; normal left atrium and left ventricle; small aorta.

DDX OF ACYANOTIC CONGENITAL HEART DISEASE WITH INCREASED PULMONARY BLOOD FLOW