CXRAY AND ECHO CORRELATES IN CHD

CXRAY AND ECHO CORRELATES IN CHDDR RAVI NARAYAN,MD DMASSOC. PROF AND SENIOR CONSULTANT PEDIATIC CARDIOLGYRAMAIAH NARAYANA HEART CENTRE

IntroductionCongenitalmeans from birth

Congenital heart defects (CHD) can vary from small holes in the heart to very serious malformations

How big is the problem ??CHD1/1000 live birthsIndia---180,000 babies/year Estimated 40-50,000/year will have shunt lesions(Holes in heart)Easy to diagnoseReasonably easy to treat unlike complex heart disease

ClassificationACYANOTICHoles in heart -- ASD,VSD,PDANarrow Valves -- AS, PS, MSNarrow pipe -- COA of aortaWeak muscle -- EFE/ DCM

CYANOTIC5Ts TOF,TGA,TRUNCUS,TAPVC, TR. ATRESIA2 ES EBSTEIN EISENMENGER2 SINGLES SINGLE A, SINGLE V

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WHAT IS ECHO??

ULTRASOUND OF HEART.M MODE, 2D, DOPPLER AND COLOUR DOPPLER3 DTEE

EchocardiographySecond Stethoscope * Exquisite anatomy even in neonates Structure and functionMore than 95% of cases can be sent for surgery without cath.

ROUTINE CXRAY??DO WE NEED CXRAY FOR DX OF CHD??DO WE NEED ECG FOR DX OF CHD??

SEE LEFT HEART BORDER

Fluoroscopy showing ASD device

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PLAX and PSAX Views

4C and Aortic(5C) View

ASD Device closure

PDA ductal cut

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Large VSD

CXRAYSHUNT LESIONSCARDIOMEGALYPLETHORADILATED PAEISENMENGER---PRUNING(SMALL AND MODERATE LESIONSCAN BE WITHIN NORMAL LIMITS)

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MRI TI WEIGHTED SEQUENCE

TOF PLAX

ViewsPSAX

TEE VIDEO CLIP

IS CXRAY BECOMING UNNECESSARY??As a diagnostic tool for CHD, yesCardiomegaly, especially in infants is overdiagnosedLung vascularity yesTo rule out lung pathologyPost op periodSitus dextrocardia, mesocardia, dextroversion

Hearts can come in all shapes and sizes!!

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