Congenital Heart Disease Part 3

Obstructive Congenital Heart Disease

1. Coarctation of Aorta - local constriciton of aorta almost always below the origin of the left subclavian artery at the site of the ductus arteriosus. 2 classic forms- infantile and adult. accompanied by bicuspid aortic valve (normally semilunar valves have three cusps). associated with saccular aneurysm of CNS and is associated with Turner's syndrome.

complications - rupture of dissecting anneurysm, IE, heart failure, cerebral haemorrhage (lots of blood to the brain because pathway to body is cut off), stenosis or endocarditis of bicuspid aortic valve.

2. Obstructive congenital anomalies - Aortic stenosis and atresia - 3 major types

a. valvular - most common, fusion of 2/3 semilunar cusps - resulting in bicuspid aortic valve, which then becomes thickened and calcified. results in hypoplastic left heart syndrome

b. subvalvular - abnormal band of subvalvular fibroelastic tissue, thickening and immobility of aortic cusps.

c. supravalvular - stenosis above the valve.