Congenital Heart Disease (CHD)
ICD-10 code: Q24.9 DESCRIPTION Structural abnormalities of the heart or great vessels present at birth. They fall into 4 pathophysiological groups: Acyanotic left to right shunts – ventricular septal defect (VSD), patent duct arteriosus (PDA), atrial septal defect (ASD), atrioventricular septal defect (AVSD). Acyanotic obstructive lesions – pulmonary stenosis, aortic stenosis, coarctation o
ICD-10 code: Q24.9
DESCRIPTION
Structural abnormalities of the heart or great vessels present at birth. They fall into 4 pathophysiological groups:
- Acyanotic left to right shunts – ventricular septal defect (VSD), patent duct arteriosus (PDA), atrial septal defect (ASD), atrioventricular septal defect (AVSD).
- Acyanotic obstructive lesions – pulmonary stenosis, aortic stenosis, coarctation of the aorta.
- Cyanotic CHD – mostly right to left shunts – tetralogy of Fallot (TOF), pulmonary atresia (PA), truncus arteriosus, total anomalous pulmonary venous drainage (TAPVD), tricuspid atresia (TA), but including parallel circulation – transposition of great arteries (TGA) (See: Prematurity and Neonatal Conditions, Cyanotic Heart Disease in the Newborn) and Eisenmenger syndrome.
- Regurgitant lesions – aortic incompetence (AI), mitral incompetence (MI) which are not common in CHD.
Some patients with CHD present with life threatening symptoms in the newborn period, See: Prematurity and Neonatal Conditions, Heart Failure in Neonates. Left to right shunts, if large, may be symptomatic due to pulmonary over circulation and pulmonary hypertension or if small may present with an incidental murmur. Many will require surgery but this may follow a period of medical therapy.
Obstructive lesions are often asymptomatic until they precipitate ventricular failure or symptoms related to decreased cardiac output. The management is usually surgical or interventional. Angiotensin-converting enzyme inhibitors (ACE-inhibitors) should be avoided in the treatment of heart failure in patients with obstructive lesions. Right to left shunts present with cyanosis and variable degrees of effort intolerance. Patients with tetralogy of Fallot may present with hypercyanotic spells.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 4: Cardiovascular System , 4.2 Congenital Heart Disease
Click here for 4.2.1: Cyanotic Congential Heart Disease With Hypoxaemia Attack/Spells (Hypercyanotic Spells)
Click here for 4.2.2: Tetralogy of Fallot
Click here for 4.2.3: Congenital Heart Disease With Left to Right Shunt