Endocardial cushion defect

Introduction to endocardial pad defect Endocardial pad defects are also referred to as atrioventricular septal defects or atrioventricular pathway defects. Embryonic stage due to developmental disorders during endocardial cushion fusion of the ventricular inflow tract, including malformations of large ventricular septal defect under the atrioventricular valve, atrial septal defect near the atrioventricular valve plane, single or common atrioventricular valve orifice , accounting for 4% of congenital heart disease, more than half of patients with congenital type (Down syndrome). Patients with complete endocardial pad defect have multiple left-to-right shunts due to mutual communication between the four heart chambers. The right ventricle and pulmonary artery pressure are equal to the ventricular pressure. From the time of birth, there is severe pulmonary hypertension and progressive aggravation. . Patients often have an apparent increase in pulmonary vascular resistance within a few months after birth. Patients with congenital (Down syndrome) progress faster in pulmonary hypertension. Atrioventricular valve regurgitation increases ventricular volume load and aggravates pulmonary hypertension and congestive heart failure, so early surgery is essential. basic knowledge The proportion of illness: 0.0015% Susceptible people: no special people Mode of infection: non-infectious Complications: mitral regurgitation tricuspid regurgitation

Endocardial pad defect cause

The left-to-right shunt at the atrial and ventricular levels results in a significant amount of pulmonary blood flow in almost all patients with endocardial pad defects. If there is no ventricular septal defect, hemodynamics resembles a large atrial septal defect and the right ventricular stroke increases. The counterflow through the atrioventricular valve lobes increases with time, and the left-to-right shunt is greater, with progressive progressive cardiac enlargement and congestive heart failure.

Patients with complete endocardial pad defect have multiple left-to-right shunts due to mutual communication between the four heart chambers. The right ventricle and pulmonary artery pressure are equal to the ventricular pressure. From the time of birth, there is severe pulmonary hypertension and progressive aggravation. . Patients often have an apparent increase in pulmonary vascular resistance within a few months after birth. Patients with congenital (Down syndrome) progress faster in pulmonary hypertension. Atrioventricular valve regurgitation increases ventricular volume load and aggravates pulmonary hypertension and congestive heart failure, so early surgery is essential.

Endocardial cushion defect prevention

Pregnant women should go to the hospital regularly for examination during pregnancy.

Endocardial pad defect complications Complications mitral regurgitation tricuspid regurgitation

In addition to the lung circulation resistance exceeding 70% of the systemic resistance, it is contraindicated for surgery. All types of atrioventricular tube malformations should be performed early. Complications include:

1. Residual atrial or ventricular septal defect.

2, abnormal cardiac conduction (arrhythmia and complete heart block).

3, mitral regurgitation.

4, tricuspid regurgitation.

Endocardial pad defect symptoms Common symptoms Ventricular septal defect Respiratory failure Shortness of breath Atrial septal defect Repeated upper respiratory tract infection Infant feeding difficulties Weekly sweating heart failure

Partial type

Symptoms of patients with small flow rates may not be obvious, and heart murmurs are only found during physical examination. Patients with larger shunts may experience severe sweating, shortness of breath, difficulty in feeding, repeated upper respiratory tract infections, growth retardation, limited activity, and congestive heart failure.

Full type

Patients with complete endocardial cushion defects have typical symptoms of congestive heart failure early in life, including repeated upper respiratory tract infections, difficulty feeding, weight loss, and sweating while eating. Physical examination revealed tachycardia, difficulty breathing, hepatomegaly, and increased pulsation in the anterior region. If the atrioventricular valve regurgitation is obvious, a loud systolic murmur will be heard. The chest radiograph shows double chamber and pulmonary congestion. ECG showed double-chamber hypertrophy, prolonged PR interval, and left-axis deviation of the motor axis.

Endocardial cushion defect examination

Two-dimensional echocardiography

It has become a routine means of diagnosing endocardial pad defects. It can clarify the nature of valve abnormalities, the shape of ventricular septal defect and atrial septal defect, and the combined malformation.

Color Doppler

Provides accurate atrial, ventricular shunt and atrioventricular regurgitation.

Cardiac catheter

Currently limited to estimating pulmonary vascular resistance to determine whether there are indications for surgery.

Diagnosis and diagnosis of endocardial cushion defect

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

Distinguish from congenital mitral valve malformation and tricuspid valvular deformity.

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