心血管系统疾病-先天性心脏病（英文）.ppt

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1、CongenitalHeartDiseaseJieTianM.D.Children’sHospitalofCUMSEpidemiologyofCHDPrevalenceCHDoccursin0.5-0.8%oflivebirths;Theincidenceishigheramongstillborns死产(3-4%),abortuses流产(10-25%),andprematureinfants(about2%excludingPDA);About2-3in1,000newborninfantswillbesymptomaticwithh

2、eartdiseaseinthefirstyearoflife.EpidemiologyofCHDPrevalenceThediagnosisisestablishedby1weekofagein40-50%ofpatientswithCHDandby1monthofagein50-60%patients;Withtheadvancesinbothpalliative姑息andcorrectivesurgeryofthelast20years,thenumberofchildrenwithCHDsurvivingtoadulthoodha

3、sincreaseddramatically;EpidemiologyofCHDPrevalenceDespitetheseadvances,CHDremainstheleadingcauseofdeathinchildrenwithcongenitalmalformations;Mostcongenitaldefectsarewelltoleratedinthefetusbecauseoftheparallelnatureofthefetalcirculation.EpidemiologyofCHDEtiologyThecauseofm

4、ostCHDisunknown.GeneticfactorsplaysomeroleinCHD.Abouteightpercentofcasesresultmainlyfromgeneticfactors.TheheartdefectisusuallypartofachromosomaldisordersuchasDown'ssyndrome.However,nospecificgenelocusforCHDhasbeenidentified.EpidemiologyofCHDEtiologyAchildborntoaparentwith

5、CHDhasasubstantially大体上increasedlikelihoodofhavingasimilarcongenitallesion.Theriskmaybeashighas15percent.Forcertainlesions,thereappearstobeagreaterriskoftransmissionfromthemotherthanfromthefather.EpidemiologyofCHDEtiologyAbouttwopercentofcasesofCHDareprimarilytheresultofe

6、nvironmentalorexternalfactors.Suchfactorsincluderubella风疹infectionandingestionofcertaindrugs,suchaslithium锂.CHDisaprominentcomponentofthefetalalcoholsyndrome.Theetiologicroleofotheragents,suchasanticonvulsantmedicationsandexogenous外源femalesexhormones,isuncertain.Noninvasi

7、veDiagnosticStudiesChestXrayThelocationoftheheartThesizeoftheheartTherelationshipbetweenheartandgreatvesselThebloodflowofthelungNoninvasiveDiagnosticStudiesEchocardiographyEchocardiographyhasgreatvalueinassessingcongenitalcardiacanomaliesandshouldusuallybethefirstadvanced

8、diagnosticstudytobecarriedoutifthehistory,thephysicalexamination,thechestXray,andtheelectrocardi