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| {{Infobox_Disease |
| | #Redirect[[Congenital heart disease]] |
| Name = {{PAGENAME}} |
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| Image = Congenital heart defect 0003.jpg|
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| Caption = Subvalvular Ventricular Septal Defect: Gross, good view of defect with overriding aorta. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
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| DiseasesDB = 17017 |
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| ICD10 = {{ICD10|Q|20||q|20}}-{{ICD10|Q|26||q|20}}|
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| ICD9 = {{ICD9|745}}-{{ICD9|747}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D006330 |
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| }}
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| {{SI}}
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| {{CMG}}
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| '''Associate Editor-in-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
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| ==Overview==
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| A '''congenital heart defect''' (CHD) is a defect in the structure of the [[heart]] and [[great vessels]] of a [[newborn]]. Most heart defects either obstruct [[blood flow]] in the heart or [[blood vessel|vessels]] near it or cause blood to [[circulatory system|flow]] through the heart in an abnormal pattern, although other defects affecting heart rhythm (such as [[long QT syndrome]]) can also occur. Heart defects are among the most common [[birth defect]]s and are the leading cause of birth defect-related deaths.
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| Congenital heart defects can be broadly categorized into two groups, [[acyanotic heart defect]]s ("pink" babies) and [[cyanotic heart defect]]s ("blue" babies).
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| == Defects ==
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| *[[Aortic stenosis]]
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| *[[Atrial septal defect]] ('''ASD''')
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| *[[Atrioventricular septal defect]] ('''AVSD''')
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| *[[Cardiomyopathy]]
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| *[[Coarctation of the aorta]] ('''CoA''')
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| *[[Dextrocardia]]
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| *[[Ebstein's anomaly]]
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| *[[Hypoplastic left heart syndrome]] ('''HLHS''')
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| *[[Interrupted aortic arch]] ('''IAA''')
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| *[[levo-Transposition of the great arteries]] ('''l-TGA''')
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| *[[Partial anomalous pulmonary venous connection]] ('''PAPVC''')
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| *[[Patent ductus arteriosus]] ('''PDA''')
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| *[[Pulmonary atresia]]
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| *[[Pulmonary stenosis]]
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| *[[Tetralogy of Fallot]] ('''ToF''')
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| *[[Total anomalous pulmonary venous connection]] ('''TAPVC''')
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| *[[dextro-Transposition of the great arteries]] ('''d-TGA''')
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| *[[Tricuspid atresia]]
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| *[[Truncus arteriosus]]
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| *[[Ventricular septal defect]] ('''VSD''')
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| *[[Bicuspid aortic valve]]
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| *[[Mitral Stenosis]]
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| ==Epidemiology==
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| ( Affecting approximately one in every 125 babies born, congenital heart defects are the most common birth defect (March of Dimes)[http://www.marchofdimes.com/pnhec/4439_1212.asp]. Forty thousand people are born each year with a CHD; 4,000 will not survive their first year(The Children's Heart Foundation). Twice as many children die each year from a CHD than all forms of Pediatric Cancers combined (The Children's Heart Foundation). The eight most common defects account for 80% of all congenital heart diseases, while the remaining 20% consist of many independently infrequent conditions or combinations of several defects. [[Ventricular septal defect]] (VSD) is generally considered to be the most common type of malformation, accounting for about 1/3 of all congenital heart defects.
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| The incidence is higher when a parent or a sibling has a heart defect (4–5%), in [[stillborns]] (3–4%), abortuses (10–25%), and [[premature infants]] (2%).
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| The number of adults with problems connected to a congenital heart defect is rising, passing the number of children with congenital heart defects in most Western countries. This group is referred to as [[GUCH|grown-up congenital heart disease (GUCH)]] patients.
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| Twice as many children die from a CHD than from all forms of pediatric cancers combined.
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| ==Etiology==
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| The cause of most congenital heart defects is unknown.
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| Where a cause is known, it may be of a multifactorial origin and/or a result of genetic [[predisposition]] and environmental factors.
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| Known genetic causes of heart disease includes chromosomal abnormalities such as [[trisomy|trisomies]] [[Down syndrome|21]], [[Patau's syndrome|13]], and [[Edward's syndrome|18]], as well as a range of newly recognised genetic [[point mutation]]s, [[point deletion]]s and other genetic abnormalities as seen in syndromes such as [[Chromosome 22, microdeletion 22 q11|CATCH 22]], familial [[ASD]] with [[heart block]], [[Alagille syndrome]], [[Noonan syndrome]], and many more.
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| Known [[antenatal]] environmental factors include maternal [[infection]]s ([[Rubella]]), [[medication|drugs]] ([[alcoholic beverage|alcohol]], [[hydantoin]], [[lithium]] and [[thalidomide]]) and maternal illness ([[diabetes mellitus]], [[phenylketonuria]], and [[lupus erythematosus|systemic lupus erythematosus]]).
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| ==Relation of congenital heart defects with sex==
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| According to "Teratological rule of sexual dimorphism" (V. Geodakian, 1970), inborn anomalies that have atavistic nature appear more frequently among females, and futuristic anomalies appear among males. This rule was applied to explain differences in sex ratio observed for congenital heart defects.<ref> Geodakyan V. A., Sherman A. L. (1970). “Eksperimental’naja hirurgija i anesteziologija (Experimental surgery and anesthesiology) ” '''32''' N 2, 18–23. </ref><ref>{{cite journal |author=Geodakian VA, Sherman AL |title=[Relation of congenital anomalies to sex] |language=Russian |journal=Zh. Obshch. Biol. |volume=32 |issue=4 |pages=417-24 |year=1971 |pmid=5146394 |doi=}}</ref>
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| In the 32,000 diagnoses of "female" malformations, those relating to the heart of the embryo and to the phylogenetic human predecessors predominated (Table). The most well-defined female's defects are patent ductus arteriosus (1♂ : 2.72♀), Lutembacher disease (1♂ : 2.1♀), and ostium secundum (1♂ : 1.84♀).
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| :{| class="wikitable"
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| |+ '''Sex ratio of patients with congenital heart defects'''
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| ! Congenital heart defect !! Sex ratio, males:females
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| |-
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| | Patent ductus arteriosus || 1 ''':''' 2.72
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| |-
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| | Lutembaher disease || 1 ''':''' 2.14
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| |-
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| | Ostium secundum || 1 ''':''' 1.84
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| |-
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| | Ventricular septal defect and patent ductus arteriosus || 1 ''':''' 1.51
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| |-
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| | Fallot's triad || 1 ''':''' 1.45
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| |-
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| | Eisenmenger's complex || 1 ''':''' 1.40
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| |-
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| | Partial atrioventricular canal || 1 ''':''' 1.36
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| |-
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| | Ostium primum || 1 ''':''' 1.20
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| |-
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| | Partial anomalous pulmonary venous connection || 1 ''':''' 1.19
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| |-
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| | Ventricular septal defect || 1 ''':''' 1.02
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| |-
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| | Potts and Waterston-Cooley shunts || 1 ''':''' 1.01
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| |-
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| | Atrioventricular canal || 1 ''':''' 1.01
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| |-
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| | Ebstein's anomaly || 1.02 ''':''' 1
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| | Stenosis of lung artery || 1.04 ''':''' 1
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| |-
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| | Tricuspid atresia || 1.16 ''':''' 1
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| | Truncus arteriosus || 1.21 ''':''' 1
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| | Tetralogy of Fallot || 1.35 ''':''' 1
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| | Coarctation of aorta and an open arterial channel || 1.37 ''':''' 1
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| | Total anomalous pulmonary venous connection || 1.39 ''':''' 1
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| | Transposition of the great arteries || 1.90 ''':''' 1
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| |-
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| | Coarctation of the aorta || 2.14 ''':''' 1
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| |-
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| | Aortic stenosis || 2.66 ''':''' 1
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| |}
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| Most well-defined "male" congenital heart defects are: aortic stenosis (2.66♂ : 1♀), coarctation of the aorta (2.14♂ : 1♀), transpositions of the great arteries (1.90♂ : 1♀), a total anomalous pulmonary venous connection (1.39♂ : 1♀), and coarctation of aorta with an open arterial channel (1.37♂ : 1♀). None of the male's components of congenital heart defects have a corresponding similar formation at normal embryo or at phylogenetic predecessors of the humans. They can be considered as unsuccessful tests of the evolution process.
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| Other congenital heart defects are of a neutral type. The frequency of occurrence is about the same for both sexes. Among them it is also possible to allocate simple (Potts/Waterston-Cooley shunt and ostium primum) and complex (partial and full atrioventricular canal, Ebstain's anomaly and tricuspid atresia) defects. Simple defects of this group, as well as female defects, can be considered atavistic. The difference between them is that these defects, contrary to female ones, represent a return to the far past in the onthogenetic and phylogenetic sense. They can be considered as a consequence of a block in heart development at early stages of embriogenesis (the first 2-3 months of the embryo's life during which the anatomic formation of the heart occurs), and at earlier (in comparison to female defects) stages of phylogenesis. For complex defects of the neutral group, the sex ratio depends on which of their components prevail—female or male.
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| Rokitansky (1875) explained congenital heart defects as breaks in heart development at various ontogenesis stages.<ref> Rokitarisky K. E. (1875) Die defecte der Scheidewande des Herzens. Wien.</ref> Spitzer (1923) treats them as returns to one of the phylogenesis stages.<ref> Spitzer A. (1923) Arch. Pathol. Anat. '''243''', 81–272. </ref> Krimsky (1963), synthesizing two previous points of view, considered congenital heart diseases as a stop of development at a certain stage of ontogenesis, corresponding to this or that stage of the phylogenesis.<ref> Krimski L. D. (1963) Pathological anatomy of congenital heart defects and complications after their surgical treatment. M., Medicine. </ref> Hence these theories can explain atavistic heart diseases only (feminine and neutral, according to our classification), and no explanation has been found for masculine defects.
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| The concept allows considering sex of the patient as a diagnostic symptom. This symptom is stable and cheap and does not harm the patient compared to some invasive diagnostic procedures.
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| ==Major categories==
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| ===Patent ductus arteriosus===
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| {{main|Patent ductus arteriosus}}
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| The [[ductus arteriosus]] is a temporary pathway in the [[fetus|foetal]] heart between the [[pulmonary artery]] and [[aorta]], which allows blood to bypass the fetus's nonfunctioning lungs until birth. Normally, the ductus closes within a few hours or days of birth; when it does not, the result is patent ductus arteriosus. This defect is common in [[premature birth|premature]] infants but rare in full-term infants.
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| ===Hypoplasia===
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| {{main|Hypoplastic left heart syndrome}}
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| [[Hypoplasia]] can affect the heart, which typically results in the failure of either the [[right ventricle]] or the [[left ventricle]] to develop adequately, leaving only one side of the heart capable of pumping blood to the body and [[lung]]s. Hypoplasia of the heart is rare but is the most serious form of CHD; it is called [[hypoplastic left heart syndrome]] when it affects the left side of the heart and [[hypoplastic right heart syndrome]] when it affects the right side of the heart. In both conditions, the presence of a [[patent ductus arteriosus]] (and, when hypoplasia affects the right side of the heart, a [[patent foramen ovale]]) is vital to the infant's ability to survive until emergency heart surgery can be performed, since without these pathways blood cannot circulate to the body (or lungs, depending on which side of the heart is defective). Hypoplasia of the heart is generally a [[cyanotic heart defect]].
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| ===Obstruction defects===
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| Obstruction defects occur when heart valves, arteries, or veins are [[stenosis|abnormally narrow]] or [[atresia|blocked]]. Common obstruction defects include [[pulmonary valve stenosis]], [[aortic valve stenosis]], and [[aortic coarctation|coarctation of the aorta]], with other types such as [[bicuspid aortic valve stenosis]] and [[subaortic stenosis]] being comparatively rare. Any narrowing or blockage can cause heart enlargement or [[hypertension]].
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| ===Septal defects===
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| The septum is a wall of tissue which separates the [[left heart]] from the [[right heart]]. It is comparatively common for defects to exist in the [[interatrial septum]] or the [[interventricular septum]], allowing blood to flow from the left side of the heart to the right, reducing the heart's efficiency. [[Ventricular septal defect]]s are collectively the most common type of CHD, although approximately 30% of adults have a type of [[atrial septal defect]] called [[patent foramen ovale]]. Septal defects may or may not cause [[cyanosis]] depending on the severity of the defect.
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| ===Cyanotic defects===
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| [[Cyanotic heart defect]]s are called such because they result in [[cyanosis]], a bluish-grey discoloration of the skin due to a lack of [[oxygen]] in the body. Such defects include [[persistent truncus arteriosus]], [[total anomalous pulmonary venous connection]], [[tetralogy of Fallot]], [[transposition of the great vessels]], and [[tricuspid atresia]].
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| ===Other defects===
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| *[[Ebstein's anomaly]]
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| *[[Brugada syndrome]]
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| *[[Marfan syndrome]]
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| *[[22q11.2 deletion syndrome|DiGeorge Syndrome]]
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| ==Signs and Symptoms==
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| Symptoms and signs are related to the type and severity of the heart defect. Some children have no signs while others may exhibit shortness of breath, cyanosis, chest pain, syncope, sweating, [[heart murmur]], respiratory infections, underdeveloping of limbs and muscles, poor feeding, or poor growth. Most defects cause a whispering sound, or murmur, as blood moves through the heart causing some of these symptoms. All of these symptoms occur at a young age of a child or infant and are typically found during a physical examination.
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| ==Treatment==
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| Sometimes CHD improves with no treatment necessary. At other times the defect is so small and does not require any treatment. Most of the time CHD is serious and requires surgery and/or medications. Medications include diuretics, which aid the baby in eliminating water, salts, and digoxin and in strengthening the contraction of the heart. This slows the heartbeat and removes some fluid from tissues. Some defects require surgical procedures to repair as much as possible to restore circulation back to normal. In some cases, multiple surgeries are needed to be performed to help balance the circulation. Interventional cardiology now offers patients minimally invasive alternatives to surgery. Device closures can now be treated with a standard transcatheter procedure using a closure device mounted on a balloon catheter.
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| ==Pathological Findings==
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| [http://www.peir.net Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0001.jpg|Tetralogy of Fallot: Gross, a good example of repaired perimembranous septal defect
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| Image:Congenital heart defect 0002.jpg|Interventricular Septal Defect (Muscular Septum): Gross, natural color, muscular septal defect in newborn
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| Image:Congenital heart defect 0003.jpg|Subvalvular Ventricular Septal Defect: Gross, good view of defect with overriding aorta
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0004.jpg|Ventricular Septal Defect: Gross, infant heart, pulmonary outlet, muscular septal defect
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| Image:Congenital heart defect 0005.jpg|Atrioventricular Canal: Gross, right ventricular view of canal defect
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| Image:Congenital heart defect 0006.jpg|Atrioventricular Canal: Gross, left ventricle view of canal defect (very good example)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0007.jpg|Perimembranous Ventricular Septal Defect: Gross, an excellent example
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| Image:Congenital heart defect 0008.jpg|Ventricular Septal Defect: Gross, subvalvular defect, left ventricle view of tetralogy of Fallot (very good example)
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| Image:Congenital heart defect 0009.jpg|Tetralogy of Fallot: Gross, close-up of aortic valve with subvalvular septal defect with Dacron patch (very good example)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0010.jpg|Subpulmonic Ventricular Septal Defect: Gross, a well shown lesion.
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| Image:Congenital heart defect 0011.jpg|Subvalvular Ventricular Septal Defect
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| Image:Congenital heart defect 0012.jpg|Subvalvular Ventricular Septal Defect
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0013.jpg|Ventricular Septal Defect: Gross, natural color, view of opened heart with lungs attached shows rather well a subvalvular VSD
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| Image:Congenital heart defect 0014.jpg|Atrioventricular Canal: Gross, patch repair of defect seen from left side showing left atrial portion extending into a cleft mitral valve
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| Image:Congenital heart defect 0015.jpg|Atrioventricular Canal: Gross, corrected defect with patch viewed from left side atrium and cleft mitral valve
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0016.jpg|Atrial Septal Defect: Gross, (an excellent example) foramen ovale defect with right ventricular hypertrophy and fatty infiltration of the right ventricular wall, enlarged right atrium
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| Image:Congenital heart defect 0017.jpg|Ventricular Septal Defect: Gross close-up adult heart, small perimembranous septal defect (very good example)
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| Image:Congenital heart defect 0018.jpg|Interventricular Septal Defect (Muscular Septum): Gross, natural color, low septal defect shown from aortic outlet. The same defect (with a probe in hole) shown from right ventricle.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0019.jpg|Interventricular Septal Defect (Muscular Septum): Gross natural color right ventricular outlet (probe in defect) view from left ventricular side
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| Image:Congenital heart defect 0020.jpg|Atrial Septal Defect: Gross natural color infant heart foramen ovale defect, septum secundum
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| Image:Congenital heart defect 0021.jpg|Aortic Subvalvular Ventricular Septal Defect: Gross, natural color, septal defect has patch repair. Aortic valve is myxomatous. A complex case of truncus with interrupted arch.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0022.jpg|Interventricular Septal Defect Membranous Septum: Gross natural color close-up (an excellent demonstration)
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| Image:Congenital heart defect 0023.jpg|Interventricular Septal Defect Membranous Septum: Gross natural color small defect well shown. Aortic cusps are scarred and one is perforated
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| Image:Congenital heart defect 0024.jpg|Subvalvular Ventricular Septal Defect: Gross, natural color, close-up view of aortic outflow tract with a large subvalvular defect
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0025.jpg|Membranous Interventricular Septal Defect: Gross natural color subvalvular defect with probe immediately inferior to membranous septum
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| Image:Congenital heart defect 0026.jpg|Subvalvular Ventricular Septal Defect: Gross, fixed tissue, large subpulmonic defect apparently represent left displacement of the pulmonary artery
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| Image:Congenital heart defect 0027.jpg|Interventricular Septal Defect: Gross, fixed tissue, opened right ventricular outflow tract positioned to show perimembranous septal defect (as surgeon would see it during repair)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0028.jpg|Ventricular Septal Defect Muscular: Gross, natural color, view from right ventricle with probe in defect right ventricular hypertrophy is evident
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| Image:Congenital heart defect 0029.jpg|Ventricular Septal Defect Muscular: Gross, natural color, view from left ventricle with probe in defect
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| Image:Congenital heart defect 0030.jpg|Interventricular Septal Defect Subvalvular with Patch Repair: Gross natural color 19yo with Tetralogy of Fallot also shows overriding aorta
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0031.jpg|Interventricular Septal Defect Subvalvular with Patch Repair: Gross, natural color, close-up
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| Image:Congenital heart defect 0032.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, natural color, view from right ventricle. A case of inverted ventricles
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| Image:Congenital heart defect 0033.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, natural color, view from left ventricular outflow tract
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0034.jpg|Ventricular Septal Defect (Subvalvular): Gross, fixed tissue, small heart with opened aorta and subvalvular defect shown. A case of pulmonary artery atresia
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| Image:Congenital heart defect 0035.jpg|Truncus Arteriosus with Subvalvular Ventricular Septal Defect: Gross, natural color, an excellent view of subvalvular defect. Quadricuspid truncus valve and type I origin of pulmonary arteries
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| Image:Congenital heart defect 0036.jpg|runcus Arteriosus with Subvalvular Interventricular Septal Defect: Gross, natural color, defect is shown from the right side (view toward right ventricular outlet)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0037.jpg|Truncus Arteriosus with Subvalvular Interventricular Septal Defect: Gross natural color excellent view of lesion looking at opened aortic ring with quadricuspid aortic valve. A large subvalvular defect (origin of pulmonary arteries is at forceps)
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| Image:Congenital heart defect 0038.jpg|Av Canal with Left Side Bjork Shiley Prosthetic Valve: Gross, natural color, a close-up view of valve and the bridging defect
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| Image:Congenital heart defect 0039.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, fixed tissue, a close-up view of patch repair from right ventricle
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0040.jpg|Conduit Right Ventricle to Pulmonary Artery: Gross, fixed tissue, opened conduit showing sutures into ventricle and patch closed perimembranous interventricular septal defect
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| Image:Congenital heart defect 0041.jpg|Ventricular Septal Defect (Perimembranous): Gross, natural color, (quite good photo - lesion before the operation)
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| Image:Congenital heart defect 0042.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Tetralogy of Fallot; Gross, fixed tissue, close-up view of a large subvalvular defect repaired with a Dacron patch (overgrown with fibrous tissue prominent subaortic shelf with endocardial thickening).
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0043.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Tetralogy of Fallot; Gross, fixed tissue, close-up view of a large subvalvular defect repaired with a Dacron patch
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| Image:Congenital heart defect 0044.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Gross, fixed tissue, close-up view of Dacron patch. Nearly completely covered with fibrous tissue
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| Image:Congenital heart defect 0045.jpg|Transposition Great Vessels with Interventricular Septal Defect: Gross, fixed tissue, opened left ventricular outflow tract into a pulmonary artery (perimembranous defect)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0046.jpg|Transposition Great Vessels with Interventricular Septal Defect: Gross, fixed tissue, close-up of interventricular septal defect and pulmonary valve
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| Image:Congenital heart defect 0047.jpg|Double Outlet Right Ventricle: Gross, fixed tissue, close-up view of left ventricular outflow tract and patched ventricular septal defect. The override is obvious in this (very good) close-up view
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| Image:Congenital heart defect 0048.jpg|Perimembranous Ventricular Septal Defect: Gross, fixed tissue, opened left ventricular outflow tract into aorta. Defect was patched 3 days prior to death
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0049.jpg|Perimembranous Ventricular Septal Defect: Gross, fixed tissue, lesion seen from right ventricle (with patch)
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| Image:Congenital heart defect 0050.jpg|Perimembranous Interventricular Septal Defect: Gross, fixed tissue, view from right atrium and ventricle with patch placed three days prior to death.
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| Image:Congenital heart defect 0051.jpg|Ventricular septal defect
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0052.jpg|Ventricular septal defect, view from left ventricle
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| Image:Congenital heart defect 0053.jpg|Atrial Septal Defect, Septum Primum; View from Right Atrium (a 4 month old baby)
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| Image:Congenital heart defect 0054.jpg|Atrial Septal Defect, Septum Primum; Also Cleft in Anterior Cusp of Mitral Valve
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Hypoplastic left ventricle 1.jpg|Hypoplastic left ventricle
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| Image:Hypoplastic left ventricle 2.jpg|Hypoplastic left ventricle
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| Image:Hypoplastic left ventricle 3.jpg|Hypoplastic left ventricle
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Hypoplastic left ventricle 4.jpg|Hypoplastic left ventricle
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| Image:Hypoplastic left ventricle 5.jpg|Hypoplastic left ventricle
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| Image:Hypoplastic left ventricle.jpg|Hypoplastic left ventricle
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:821.jpg|Patent Ductus Arteriosus: Gross example in an infant heart
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| Image:4433.jpg|Patent Ductus Arteriosus: Gross fixed tissue probe in ductus
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:5320.jpg|Patent Ductus Arteriosus: Gross fixed tissue view of ductus opened from pulmonary artery into aorta with edematous appearing intimal surface
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| Image:5338.jpg|Patent Ductus Arteriosus: Gross natural color opened ductus in infant shows apparent intimal edema in ductus.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:6818.jpg|Patent Ductus Arteriosus with Aneurysmal Dilation: Gross fixed tissue external photo of heart shows the lesion
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| Image:6819.jpg|Patent Ductus Arteriosus with Aneurysmal Dilation: Gross fixed tissue aorta and ductus have been cross sectioned showing arch of aorta and huge ductus in a 5 day old infant
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:6820.jpg|Patent Ductus Arteriosus with Aneurysmal Dilation: Gross fixed tissue opened aortic arch and descending thoracic showing very large opening of ductus into aorta
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| Image:249019.jpg|Patent Ductus Arteriosus
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:3240.jpg|Right Ventricle Hypoplasia: Gross natural color good example showing tiny tricuspid inlet and very small but quite thick right ventricle
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| Image:3241.jpg|Right Ventricle Hypoplasia: Gross natural color view from right atrium showing patent foramen ovale and very small tricuspid valve
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| Image:3242.jpg|Right Ventricle Hypoplasia: Gross natural color external view of heart showing very large left ventricle and very small right ventricle delineated by anterior descending branch of left coronary artery
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| </gallery>
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| </div>
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| ==References==
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| {{Reflist|2}}
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| ==See Also==
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| * [[Congenital heart disease]]
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| ==External Links==
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| *[http://www.itsmyheart.org/ It's My Heart, Inc. - A National Non-Profit Organization who supports and advocates for those affected by Congenital Heart Defects]
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| *{{DMOZ|Health/Conditions_and_Diseases/Cardiovascular_Disorders/Heart_Disease/Congenital/}}
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| * [http://www.congenitalheartdefects.com/ General information about congenital heart defects]
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| *[http://www.dhg.org.uk Down's Heart Group. A charity offering support and information relating to heart conditions associated with Down's Syndrome.]
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| {{Congenital malformations and deformations of circulatory system}}
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| [[Category:Congenital heart disease]]
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| [[Category:Cardiology]]
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| [[de:Herzfehler]]
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| [[fr:Cardiopathie congénitale]]
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| [[nn:Medfødd hjartefeil]]
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| [[pl:Wada serca]]
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| [[sr:Урођене срчане мане]]
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| {{WH}}
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| {{WS}}
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