Dr Akashdeep Bhatia

Developmement of Heart

Embryonic structureGives rise to Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atria Left horn of sinus venosus Right horn of sinus venosus Ascending aorta and pulmonary trunk Smooth parts of left and right ventricles Trabeculated left and right ventricles Trabeculated left and right atria Coronary sinus Smooth part of right atrium

Interatrial septum development

Interartrialseptal related congenital anomalies Atrial septal defect Two types 1)primum type: persistent of foramen primum Lt to Rt shunt Overload in pulmonary circulation (pul HTN)lead to Rt to Lt shunt Eisenmenger’s syndrome Acynotic to cynotic Mostly failure of endocardial cushion to go up --- inadequacy of neural crest cells. Associated with valvular defects

2)Secondary type :Formation of foramen secundum Lt to Rt shunt

Interventricular septal related congenital anomalies Tetralogy of fallot : skewed AP septun 4 components :Pulmonary stenosis overriding aorta VSD Right ventricular hypertrophy Rt to Lt shunt

Transposition of great vessels: Failure to spiral Rt to Lt shunt With patent Ductus arteriosus good prognosis Tx: Prostaglandin agonist Surgery

Patent Truncus arteriosus (Partial AP septum development ) Mixing of DO2 and O2 blood. Always present with VSD