儿童先天性心脏病Cardiovascular-Diseases-in-Children(英文课件).pptx

《儿童先天性心脏病Cardiovascular-Diseases-in-Children(英文课件).pptx》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、CongenitalHeartDiseasesinChildren（GeneralIntroduction）Dr.LiuChonghaiCardiovascularDiseasesinChildrenCongenitalheartdiseasesViralmyocarditisRheumaticheartdiseaseCardiomyopathyKawasakiDiseaseArrhythmiaCongestiveheartfailurePericarditisInfectiveendocarditisEtc….CongenitalHeartD

2、iseasesDefinition：CardiovascularmalformationspresentduringembryonicstagesCHDaccountsfornearly1/3ofallmajorcongenitalanomalies.25%arelifethreateningandrequireearlyintervention.TheprevalenceofCHDininfancyisestimatedat6-8per1000livebirths.(Indian)－7~8/1000newborns（reporteddata）

3、(China)－6.87/1000newbornsinShanghai（Epidemiologicsurveyduring1989～1991）PrevalenceEtiologicConsiderationsHereditaryfactors(Associatedwith15%CHD)Trisomiesofchromosome21,18,15,13Deletionofchromosome22q11Genedefects：－DefectsofElastininWilliam’ssyndrome－MutationsofFibrillininMarf

4、an’ssyndrome－MutationsofTbx5inHolt-Oramsyndrome－MutationsofCx43inhypoplasticleftheartEtiologicConsiderationsEnvironmentalfactorsExposedtothefollowingfactorsduringthefirsttrimesterofpregnancy－Viralinfections:rubella,influenza,enterovirus,parotitis－Physicalandchemicalfactors:d

5、rugs,radiation,alcohol,tobacco－Maternitydiseases:diabetes,connectivetissueproblems,hypertensionsyndromePathogenesisHypostasis：－Heartdevelopmentisaverycomplexprocessinvolvingmanycoordinatedsteps－AbnormalembryologicaldevelopmentoftheheartleadstoCHDMechanism：－Geneticbasisintera

6、ctedwiththeenvironmentalfactorsplayrolepossiblyinmostcasesFetalHeartDevelopmentFormationofprimitivehearttubeLoopingofprimitivehearttubeFormationofendocardialcushionFormationofinteratrialseptumFormationofinterventricularseptumSeptationofaorticandpulmonaryarteriesFormationandL

7、oopingofPrimitiveHeartTube3weeksofintrauterinelife4weeksofintrauterinelife5-6weeksofintrauterinelife7-8weeksofintrauterinelife11FetalCirculation&ChangesafterBirthafterbirthbeforebirthDifferencesbetweenthefetalandpostnatalcirculationPresenceofplacentalcirculation,whichprovid

8、esgasexchangeforthefetus.Absenceofgasflowofbloodtothelungsandthuslittlepulm