Cardiovascular System - Abnormalities

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Introduction

Data shown as a percentage of all major abnormalities based upon published statistics using the same groupings as Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352.

Heart defects and preterm birth are the most common causes of neonatal and infant death. The long-term development of the heart combined with extensive remodelling and post-natal changes in circulation lead to an abundance of abnormalities associated with this system.

A UK study literature showed that preterm infants have more than twice as many cardiovascular malformations (5.1 / 1000 term infants and 12.5 / 1000 preterm infants) as do infants born at term and that 16% of all infants with cardiovascular malformations are preterm. (0.4% of live births occur at greater than 28 weeks of gestation, 0.9% at 28 to 31 weeks, and 6% at 32 to 36 weeks. Overall, 7.3% of live-born infants are preterm)[1]

"Baltimore-Washington Infant Study data on live-born cases and controls (1981-1989) was reanalyzed for potential environmental and genetic risk-factor associations in complete atrioventricular septal defects AVSD (n = 213), with separate comparisons to the atrial (n = 75) and the ventricular (n = 32) forms of partial AVSD. ...Maternal diabetes constituted a potentially preventable risk factor for the most severe, complete form of AVSD." [2]

In addition, there are in several congenital abnormalities that exist in adults (bicuspid aortic valve, mitral valve prolapse, and partial anomalous pulmonary venous connection) which may not be clinically recognized.

Developmental abnormalities of the cardiovascular system are classified under ICD-10 as "Congenital malformations of the circulatory system (Q20-Q28)". Note that the updated release of this coding system (ICD-11) will include a coding based upon the International Pediatric Cardiac Code.[3][4]

Heart Abnormal: Tutorial Abnormalities | Atrial Septal Defects | Double Outlet Right Ventricle | Hypoplastic Left Heart | Patent Ductus Arteriosus‎ | Transposition of the Great Vessels | Tetralogy of Fallot | Ventricular Septal Defects | Category ASD | Category PDA | Category ToF |Category VSD | ICD10 - Cardiovascular | ICD11


Cardiovascular Links: Introduction | Heart Tutorial | Lecture - Early Vascular | Lecture - Heart | Movies | Heart | Coronary Circulation | Heart Valve | Heart Rate | Circulation | Blood | Blood Vessel | Blood Vessel Histology | Cardiac Muscle Histology | Lymphatic | Ductus Venosus | Spleen | Stage 22 | Abnormalities | OMIM | 2012 ECHO Meeting | 2016 Cardiac Review | Category:Cardiovascular
Historic Embryology - Cardiovascular 
1902 Vena cava inferior | 1905 Brain Blood Vessels | 1909 Cervical Veins | 1912 Heart | 1912 Human Heart | 1914 Earliest Blood-Vessels | 1915 Congenital Cardiac Disease | 1915 Dura Venous Sinuses | 1916 Pars Membranacea Septi | 1919 Lower Limb Arteries | 1921 Human Brain Vascular | 1921 Spleen | 1922 Aortic-Arch System | 1922 Pig Forelimb Arteries | 1922 Chicken Pulmonary | 1923 Head Subcutaneous Plexus | 1925 Venous Development | 1928 Heart Blood Flow | 1935 Aorta | 1935 Venous valves | 1938 Pars Membranacea Septi | 1938 Foramen Ovale | 1939 Atrio-Ventricular Valves | 1940 Vena cava inferior | 1940 Early Hematopoiesis | 1942 Truncus and Conus Partitioning | Ziegler Heart Models | 1951 Heart Movie | 1954 Week 9 Heart | 1957 Cranial venous system | 1959 Brain Arterial Anastomoses | Historic Embryology Papers | 2012 ECHO Meeting | 2016 Cardiac Review | Historic Disclaimer

Some Recent Findings

  • High throughput in vivo functional validation of candidate congenital heart disease genes in Drosophila[5] "We developed a Drosophila-based functional system to screen candidate disease genes identified from Congenital Heart Disease (CHD) patients. 134 genes were tested in the Drosophila heart using RNAi-based gene silencing. Quantitative analyses of multiple cardiac phenotypes demonstrated essential structural, functional, and developmental roles for more than 70 genes, including a subgroup encoding histone H3K4 modifying proteins. We also demonstrated the use of Drosophila to evaluate cardiac phenotypes resulting from specific, patient-derived alleles of candidate disease genes. We describe the first high throughput in vivo validation system to screen candidate disease genes identified from patients." Fly Development
  • Cyp26 Enzymes Facilitate Second Heart Field Progenitor Addition and Maintenance of Ventricular Integrity[6] "Although retinoic acid (RA) teratogenicity has been investigated for decades, the mechanisms underlying RA-induced outflow tract (OFT) malformations are not understood. Here, we show zebrafish embryos deficient for Cyp26a1 and Cyp26c1 enzymes, which promote RA degradation, have OFT defects resulting from two mechanisms: first, a failure of second heart field (SHF) progenitors to join the OFT, instead contributing to the pharyngeal arch arteries (PAAs), and second, a loss of first heart field (FHF) ventricular cardiomyocytes due to disrupted cell polarity and extrusion from the heart tube." Zebrafish Development | Developmental Signals - Retinoic acid
  • Long-Term Survival of Individuals Born With Congenital Heart Disease: A Systematic Review and Meta-Analysis[7] "Estimates of long-term survival are required to adequately assess the variety of health and social services required by those with congenital heart disease (CHD) throughout their lives. ... Among persons with CHD, the mortality rate is greatest during the first year of life; however, this systematic review and meta-analysis showed that survival decreases gradually after infancy and into adulthood."
  • Spontaneous Closure of Muscular Trabecular Ventricular Septal Defect: Comparison of Defect Positions [8] "We performed a historical cohort study for which 150 patients <3 months of age (median age, 9 days) diagnosed as having a muscular trabecular VSD were selected. ...We infer that midventricular muscular trabecular VSD tends to close spontaneously earlier and more frequently than either anterior or apical muscular trabecular VSD."
More recent papers  
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Search term: Cardiovascular Abnormality

Carlos Tavares Bello, Catarina Barreiros, Inês Gil, Carlos Vasconcelos Down syndrome and Moyamoya disease: unusual cause of stroke. BMJ Case Rep: 2017, 2017; PubMed 28647711

Meg M Sleeper Status of Therapeutic Gene Transfer to Treat Cardiovascular Disease in Dogs and Cats. Vet. Clin. North Am. Small Anim. Pract.: 2017; PubMed 28647114

Su-Zhen Dong, Ming Zhu Magnetic resonance imaging of fetal persistent left superior vena cava. Sci Rep: 2017, 7(1);4176 PubMed 28646194

Matteo Bauckneht, Giulia Ferrarazzo, Francesco Fiz, Silvia Morbelli, Matteo Sarocchi, Fabio Pastorino, Alberto Ghidella, Elena Pomposelli, Maurizio Miglino, Pietro Ameri, Laura Emionite, Flavia Ticconi, Eleonora Arboscello, Ambra Buschiazzo, Elena Augusta Massimelli, Salvatore Fiordoro, Anna Borra, Vanessa Cossu, Annalisa Bozzano, Adalberto Ibatici, Mirco Ponzoni, Paolo Spallarossa, Andrea Gallamini, Paolo Bruzzi, Gianmario Sambuceti, Cecilia Marini Doxorubicin effect on myocardial metabolism as a pre-requisite for subsequent development of cardiac toxicity: a translational (18)F-FDG PET/CT observation. J. Nucl. Med.: 2017; PubMed 28646013

Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo DI Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote, Euro-ELSO Working Group on Neurologic Monitoring and Outcome Brain monitoring in adult and pediatric ECMO patients: the importance of early and late assessments. Minerva Anestesiol: 2017; PubMed 28643997

International Classification of Diseases

The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.

ICD11

ICD-11 Structural developmental anomalies of the circulatory system (draft) 
ICD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.

20 Developmental Anomalies - Structural Developmental Anomalies

Beta coding and tree structure for "structural developmental anomalies" within this section are shown in the table below.

Structural developmental anomalies of the circulatory system  
  • Structural developmental anomaly of heart and great vessels
    • LB00 Congenital heart or great vessel related acquired abnormality
    • LB01 Congenital anomaly of atrioventricular or ventriculo-arterial connections
      • LB01.1 Transposition of the great arteries
      • LB01.2 Double outlet right ventricle
      • LB01.3 Double outlet left ventricle
      • LB01.4 Common arterial trunk
      • LB01.Y Other specified congenital anomaly of atrioventricular or ventriculo-arterial connections
      • LB01.Z Congenital anomaly of atrioventricular or ventriculo-arterial connections, unspecified
    • LB02 Congenital anomaly of the mediastinal veins Congenital anomaly of atria or atrial septum
    • LB20 Congenital anomaly of atrioventricular valves or septum
    • LB21 Congenital anomaly of ventricles and ventricular septum
      • LB21.1 Congenital right ventricular outflow tract obstruction  
      • LB21.2 Double-chambered right ventricle  
      • LB21.3 Tetralogy of Fallot
      • LB21.4 Congenital left ventricular outflow tract obstruction  
      • LB21.5 Congenital ventricular septal defects 
      • LB21.Y Other specified congenital anomaly of ventricles and ventricular septum
      • LB21.Z Congenital anomaly of ventricles and ventricular septum, unspecified  
    • LB22 Functionally univentricular heart
    • LB23 Congenital anomaly of ventriculo-arterial valves and adjacent regions
    • LB24 Congenital anomaly of great arteries including arterial duct
      • LB.1 Congenital aorto-pulmonary window
      • LB.2 Congenital anomaly of pulmonary arterial tree
      • LB.3 Congenital anomaly of aorta and its branches
      • LB.4 Tracheo-oesophageal compressive syndrome
      • LB.5 Patent arterial duct
      • LB.Y Other specified congenital anomaly of great arteries including arterial duct
      • LB.Z Congenital anomaly of great arteries including arterial duct, unspecified
    • LB25 Anomalous position-orientation of heart
    • LB26 Total mirror imagery
    • LB27 Left isomerism
    • LB28 Congenital anomaly of coronary arteries
    • LB29 Structural developmental anomalies of the pericardium
    • LB2Y Other specified structural developmental anomaly of heart and great vessels
    • LB2Z Structural developmental anomaly of heart and great vessels, unspecified
  • LB30 Structural developmental anomalies of the peripheral vascular system
    • LB30.1 Capillary malformations
    • LB30.2 Lymphatic malformations
      • LB30.21 Macrocystic lymphatic malformation
      • LB30.22 Microcystic lymphatic malformation
      • LB30.23 Cystic hygroma in fetus
      • BD23.1 Primary lymphoedema
          • EK91 Yellow nail syndrome
          • LC5F.26 Noonan syndrome
      • LB30.2Y Other specified lymphatic malformations
      • LB30.2Z Lymphatic malformations, unspecified
    • LB30.3 Peripheral venous malformations
    • LB30.4 Peripheral arteriovenous malformations
    • LB30.5 Peripheral arterial malformations
    • LB30.6 Pulmonary arteriovenous fistula
    • LB30.Y Other specified structural developmental anomalies of the peripheral vascular system
    • LB30.Z Structural developmental anomalies of the peripheral vascular system, unspecified
  • LB3Y Other specified structural developmental anomalies of the circulatory system
  • LB3Z Structural developmental anomalies of the circulatory system, unspecified
CD-11 Beta Draft - NOT FINAL, updated on a daily basis, It is not approved by WHO, NOT TO BE USED for CODING except for agreed FIELD TRIALS.


See also International Classification of Diseases | Abnormalities

ICD10

Within the ICD10 classification "congenital malformations, deformations and chromosomal abnormalities" are (Q00-Q99) but excludes "inborn errors of metabolism" (E70-E90).

Congenital malformations of the circulatory system (Q20-Q28) can be viewed in the collapsed table below. Note that the updated release of this coding system (ICD-11) will include a coding based upon the International Paediatric and Congenital Cardiac Code International Pediatric Cardiac Code. This system was initiated in 2005 by the International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD).[3][4]

ICD10 Congenital malformations of the circulatory system (Q20-Q28)  
Cardiovascular System - Abnormalities
Q20 Congenital malformations of cardiac chambers and connections

Excl.: dextrocardia with situs inversus (Q89.3) mirror-image atrial arrangement with situs inversus (Q89.3)

  • Q20.0 Common arterial trunk Persistent truncus arteriosus
  • Q20.1 Double outlet right ventricle Taussig-Bing syndrome
  • Q20.2 Double outlet left ventricle
  • Q20.3 Discordant ventriculoarterial connection Dextrotransposition of aorta Transposition of great vessels (complete)
  • Q20.4 Double inlet ventricle Common ventricle Cor triloculare biatriatum Single ventricle
  • Q20.5 Discordant atrioventricular connection Corrected transposition Laevotransposition Ventricular inversion
  • Q20.6 Isomerism of atrial appendages Isomerism of atrial appendages with asplenia or polysplenia
  • Q20.8 Other congenital malformations of cardiac chambers and connections
  • Q20.9 Congenital malformation of cardiac chambers and connections, unspecified
Q21 Congenital malformations of cardiac septa

Excl.: acquired cardiac septal defect (I51.0)

  • Q21.0 Ventricular septal defect
  • Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect
  • Q21.2 Atrioventricular septal defect Common atrioventricular canal Endocardial cushion defect Ostium primum atrial septal defect (type I)
  • Q21.3 Tetralogy of Fallot Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
  • Q21.4 Aortopulmonary septal defect Aortic septal defect Aortopulmonary window
  • Q21.8 Other congenital malformations of cardiac septa Eisenmenger's defect Pentalogy of Fallot Excl.: Eisenmenger's complex (I27.8) syndrome (I27.8)
  • Q21.9 Congenital malformation of cardiac septum, unspecified Septal (heart) defect NOS
Q22 Congenital malformations of pulmonary and tricuspid valves
  • Q22.0 Pulmonary valve atresia
  • Q22.1 Congenital pulmonary valve stenosis
  • Q22.2 Congenital pulmonary valve insufficiency Congenital pulmonary valve regurgitation
  • Q22.3 Other congenital malformations of pulmonary valve Congenital malformation of pulmonary valve NOS
  • Q22.4 Congenital tricuspid stenosis Tricuspid atresia
  • Q22.5 Ebstein's anomaly
  • Q22.6 Hypoplastic right heart syndrome
  • Q22.8 Other congenital malformations of tricuspid valve
  • Q22.9 Congenital malformation of tricuspid valve, unspecified
Q23 Congenital malformations of aortic and mitral valves
  • Q23.0 Congenital stenosis of aortic valve Congenital aortic: atresia stenosis Excl.: congenital subaortic stenosis (Q24.4) that in hypoplastic left heart syndrome (Q23.4)
  • Q23.1 Congenital insufficiency of aortic valve Bicuspid aortic valve Congenital aortic insufficiency
  • Q23.2 Congenital mitral stenosis Congenital mitral atresia
  • Q23.3 Congenital mitral insufficiency
  • Q23.4 Hypoplastic left heart syndrome Atresia, or marked hypoplasia of aortic orifice or valve, with hypoplasia of ascending aorta and defective develop-ment of left ventricle (with mitral valve stenosis or atresia).
  • Q23.8 Other congenital malformations of aortic and mitral valves
  • Q23.9 Congenital malformation of aortic and mitral valves, unspecified
Q24 Other congenital malformations of heart

Excl.: endocardial fibroelastosis (I42.4)

  • Q24.0 Dextrocardia Excl.: dextrocardia with situs inversus (Q89.3) isomerism of atrial appendages (with asplenia or polysplenia) (Q20.6) mirror-image atrial arrangement with situs inversus (Q89.3)
  • Q24.1 Laevocardia Location of heart in left hemithorax with apex pointing to the left, but with situs inversus of other viscera and defects of the heart, or corrected transposition of great vessels.
  • Q24.2 Cor triatriatum
  • Q24.3 Pulmonary infundibular stenosis
  • Q24.4 Congenital subaortic stenosis
  • Q24.5 Malformation of coronary vessels Congenital coronary (artery) aneurysm
  • Q24.6 Congenital heart block
  • Q24.8 Other specified congenital malformations of heart Congenital: diverticulum of left ventricle malformation of: myocardium pericardium Malposition of heart Uhl's disease
  • Q24.9 Congenital malformation of heart, unspecified Congenital: anomaly disease NOS of heart
Q25 Congenital malformations of great arteries
  • Q25.0 Patent ductus arteriosus Patent ductus Botallo Persistent ductus arteriosus
  • Q25.1 Coarctation of aorta Coarctation of aorta (preductal)(postductal)
  • Q25.2 Atresia of aorta
  • Q25.3 Stenosis of aorta Supravalvular aortic stenosis Excl.: congenital aortic stenosis (Q23.0)
  • Q25.4 Other congenital malformations of aorta Absence Aplasia Congenital: aneurysm dilatation of aorta Aneurysm of sinus of Valsalva (ruptured) Double aortic arch [vascular ring of aorta] Hypoplasia of aorta Persistent: convolutions of aortic arch right aortic arch Excl.: hypoplasia of aorta in hypoplastic left heart syndrome (Q23.4)
  • Q25.5 Atresia of pulmonary artery
  • Q25.6 Stenosis of pulmonary artery Supravalvular pulmonary stenosis
  • Q25.7 Other congenital malformations of pulmonary artery Aberrant pulmonary artery Agenesis Aneurysm, congenital Anomaly Hypoplasia of pulmonary artery Pulmonary arteriovenous aneurysm
  • Q25.8 Other congenital malformations of great arteries
  • Q25.9 Congenital malformation of great arteries, unspecified
Q26 Congenital malformations of great veins
  • Q26.0 Congenital stenosis of vena cava Congenital stenosis of vena cava (inferior)(superior)
  • Q26.1 Persistent left superior vena cava
  • Q26.2 Total anomalous pulmonary venous connection
  • Q26.3 Partial anomalous pulmonary venous connection
  • Q26.4 Anomalous pulmonary venous connection, unspecified
  • Q26.5 Anomalous portal venous connection
  • Q26.6 Portal vein-hepatic artery fistula
  • Q26.8 Other congenital malformations of great veins Absence of vena cava (inferior)(superior) Azygos continuation of inferior vena cava Persistent left posterior cardinal vein Scimitar syndrome
  • Q26.9 Congenital malformation of great vein, unspecified Anomaly of vena cava (inferior)(superior) NOS
Q27 Other congenital malformations of peripheral vascular system

Excl.: anomalies of: cerebral and precerebral vessels (Q28.0-Q28.3) coronary vessels (Q24.5) pulmonary artery (Q25.5-Q25.7) congenital retinal aneurysm (Q14.1) haemangioma and lymphangioma (D18.-)

  • Q27.0 Congenital absence and hypoplasia of umbilical artery Single umbilical artery
  • Q27.1 Congenital renal artery stenosis
  • Q27.2 Other congenital malformations of renal artery Congenital malformation of renal artery NOS Multiple renal arteries
  • Q27.3 Peripheral arteriovenous malformation Arteriovenous aneurysm Excl.: ac
  • Quired arteriovenous aneurysm (I77.0)
  • Q27.4 Congenital phlebectasia
  • Q27.8 Other specified congenital malformations of peripheral vascular system Aberrant subclavian artery Absence Atresia of artery or vein NEC Congenital: aneurysm (peripheral) stricture, artery varix
  • Q27.9 Congenital malformation of peripheral vascular system, unspecified Anomaly of artery or vein NOS
Q28 Other congenital malformations of circulatory system

Excl.: congenital aneurysm: NOS (Q27.8) coronary (Q24.5) peripheral (Q27.8) pulmonary (Q25.7) retinal (Q14.1) ruptured: cerebral arteriovenous malformation (I60.8) malformation of precerebral vessels (I72.-)

  • Q28.0 Arteriovenous malformation of precerebral vessels Congenital arteriovenous precerebral aneurysm (nonruptured)
  • Q28.1 Other malformations of precerebral vessels Congenital: malformation of precerebral vessels NOS precerebral aneurysm (nonruptured)
  • Q28.2 Arteriovenous malformation of cerebral vessels Arteriovenous malformation of brain NOS Congenital arteriovenous cerebral aneurysm (nonruptured)
  • Q28.3 Other malformations of cerebral vessels Congenital: cerebral aneurysm (nonruptured) malformation of cerebral vessels NOS
  • Q28.8 Other specified congenital malformations of circulatory system Congenital aneurysm, specified site NEC
  • Q28.9 Congenital malformation of circulatory system, unspecified
ICD-10 Links: XVII Congenital Malformations | System Tables | XVI Perinatal Period | XV Pregnancy Childbirth | Abnormal Development | Reports


See also ICD-10 Chapter XVI Certain conditions originating in the perinatal period (P00-P96) P29 Cardiovascular disorders originating in the perinatal period. Excl.: congenital malformations of the circulatory system (Q20-Q28)

  • P29.0 Neonatal cardiac failure
  • P29.1 Neonatal cardiac dysrhythmia
  • P29.2 Neonatal hypertension
  • P29.3 Persistent fetal circulation Delayed closure of ductus arteriosus Pulmonary hypertension of newborn (persistent)
  • P29.4 Transient myocardial ischaemia of newborn
  • P29.8 Other cardiovascular disorders originating in the perinatal period
  • P29.9 Cardiovascular disorder originating in the perinatal period, unspecified
ICD-10 Links: XVII Congenital Malformations | System Tables | XVI Perinatal Period | XV Pregnancy Childbirth | Abnormal Development | Reports
Links: Neonatal Development | International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD)

Heart Abnormalities

Ventricular Septal Defect

Ventricular Septal Defect.jpg The Ventricular Septal Defect (VSD) usually occurs in the membranous (perimembranous) rather than muscular interventricular septum, and is more frequent in males that females.

Perimembranous defects are located close to the aortic and tricuspid valves and adjacent to atrioventricular conduction bundle.

ICD-10 Q21.0 Ventricular septal defect


Links: Ventricular Septal Defects | Search PubMed

Atrial Septal Defects

Atrial Septal Defect.jpg Atrial Septal Defects (ASD) are a group of common (1% of cardiac) congenital anomolies defects occuring in a number of different forms and more often in females.
  • patent foramen ovale- allows a continuation of the atrial shunting of blood, in 25% of people a probe patent foramen ovale (allowing a probe to bepassed from one atria to the other) exists.
  • ostium secundum defect
  • endocardial cushion defect involving ostium primum
  • sinus venosus defect - contributes about 10% of all ASDs and occurs mainly in a common and less common form. Common ("usual type") - in upper atrial septum which is contiguous with the superior vena cava. Less common - at junction of the right atrium and inferior vena cava.
  • common atrium

ICD-10 Q21.1 Atrial septal defect Coronary sinus defect Patent or persistent: foramen ovale ostium secundum defect (type II) Sinus venosus defect

Treatment: The surgical repair requires a cardiopulmonary bypass and is recommended in most cases of ostium secundum ASD, even though there is a significant risk involved. Ostium primum defects tend to present earlier and are often associated with endocardial cushion defects and defective mitral or tricuspid valves. In such cases, valve replacement may be necessary and the extended operation has a considerable chance of mortality.

  • Increasingly closure by a transcatheter device closure has been applied.
  • Repair of atrial septal defects on the perfused beating heart (atrial septal defect size 2 cm - 4.5 cm) [9]


Links: Atrial Septal Defects | OMIM: Atrial Septal Defect | Search PubMed | Medline Plus - ASD Repair Video

Patent Ductus Arteriosus

Patent Ductus Arteriosus.jpg Patent ductus arteriosus (PDA), or Patent arterial duct (PAD), or common truncus, occurs commonly in preterm infants, and at approximately 1 in 2000 full term infants and more common in females (to male ratio is 2:1). Can also be associated with specific genetic defects, trisomy 21 and trisomy 18, and the Rubinstein-Taybi and CHARGE syndromes. The opening is asymptomatic when the duct is small and can close spontaneously (by day three in 60% of normal term neonates), the remainder are ligated simply and with little risk, with transcatheter closure of the duct generally indicated in older children. The operation is always recommended even in the absence of cardiac failure and can often be deferred until early childhood.

ICD-10 Q25.0 Patent ductus arteriosus Patent ductus Botallo Persistent ductus arteriosus


Links: Patent Ductus Arteriosus | Search PubMed

Tetralogy of Fallot

Tetralogy of Fallot.jpg Named after Etienne-Louis Arthur Fallot (1888) who described it as "la maladie blue" and is a common developmental cardiac defect. The syndrome consists of a number of a number of cardiac defects possibly stemming from abnormal neural crest migration.

ICD-10 Q21.3 Tetralogy of Fallot Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.


Links: Tetralogy of Fallot | Gene expression in cardiac tissues from infants with idiopathic conotruncal defects | Search PubMed

Hypoplastic Left Heart

Hypoplastic Left Heart.jpg Characterized by hypoplasia (underdevelopment or absence) of the left ventricle obstructive valvular and vascular lesion of the left side of the heart.

ICD-10 Q23.4 Hypoplastic left heart syndrome Atresia, or marked hypoplasia of aortic orifice or valve, with hypoplasia of ascending aorta and defective develop-ment of left ventricle (with mitral valve stenosis or atresia).


Links: Hypoplastic Left Heart | Search PubMed

Double Outlet Right Ventricle

Double Outlet Right Ventricle.jpg

De-oxygenated blood enters the aorta from the right ventricle and is returned to the body.

ICD-10 Q20.1 Double outlet right ventricle Taussig-Bing syndrome

Links: Double Outlet Right Ventricle | Search PubMed

Tricuspid Atresia

Tricuspid Atresia.jpg Blood is shunted through an atrial septal defect to the left atrium and through the ventricular septal defect to the pulmonary artery. The shaded arrows indicate mixing of the blood.

ICD-10 Q22.4 Congenital tricuspid stenosis Tricuspid atresia

Fontan Procedure: a surgical procedure developed by Fontan and Baudet (1971) to restore a circulation in patients with tricuspid atresia.


Links: Search PubMed | Fontan procedure

Dextrocardia

Dextrocardia heart position.jpg Dextrocardia.jpg
Dextrocardia anatomical heart position[10] Dextrocardia (postnatal 1 year old)[10]

Initial malrotation of the heart tube bending left instead of right. Results in heart and greater vessels reversed. Can also occur with situs invertus, where viscera are transposed LR.

Anatomical left-right normal asymmetry is called situs solitus. The alternative heterotaxy can be either randomization (situs ambiguus) or a complete reversal (situs inversus) of normal organ position.


Links: Chicken Abnormal Heart Movie | Search PubMed

Abnormalities of Conducting System

Cardiac Conduction System
Cardiac Conduction System

Also variously called the cardiac conduction system (CCS), cardiac pacemaking and conduction system (CPCS), or atrioventricular conduction system (AVCS). Recently animal models (CCS-lacZ transgenic mouse) have helped identify key processes in the development of this specialized conduction system.

"Known arrhythmogenic areas including Bachmann's bundle, the pulmonary veins, and sinus venosus derived internodal structures, demonstrate lacZ expression." (Jongbloed et al, 2004)


Long QT Syndrome

Congenital long QT syndrome (LQTS) is a group of rare genetic disorders with prolonged ventricular repolarization and a risk of ventricular tachyarrhythmias. Cause is mutations in genes encoding either cardiac ion channels or channel interacting proteins.

Search NCBI Bookshelf: Congenital long-QT syndrome


Links: Search PubMed

Heart Vessel Abnormalities

Transposition of the Great Vessels

Transposition of the Great Vessels.jpg Characterized by aorta arising from right ventricle and pulmonary artery from the left ventricle and often associated with other cardiac abnormalities (e.g. ventricular septal defect).
  • International Classification of Diseases code 745.1
  • Australian national rate (1982-1992) 3.6/10,000 births.
  • Of 988 infants 4.1% were stillborn and 23.2% liveborn died during neonatal period.
  • slightly more common in twin births than singleton.
  • Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352
  • Neonates with transposed great arteries die without an arterial switch operation, first carried out in 1975.
US Transposition great arteries.jpg
 ‎‎Heart TGA
Page | Play

ICD-10


LInks: Transposition of the Great Vessels | Search PubMed | PMID 15987628 | PMID 18851735

Coarctation of the Aorta

Coarctation of the Aorta.jpg
  • 5-8% of Congenital Heart Disease
  • Aortic constriction.
  • Treatment aims at maintaining the ductus arteriosus via prostaglandins and by surgical intervention.
  • Recent review[11] suggests it may:
    • affect the aortic arch in a highly variable manner
    • be associated with a host of other left sided heart lesions
    • represent a wider vasculopathy within the pre-coarctation arterial tree

ICD-10

LInks: Search PubMed | PMID 21947983 | 2011 Review PDF

Interrupted Aortic Arch

LInks: Search PubMed

Pulmonary Atresia

Pulmonary Atresia.jpg
  • Abnormal blood flow (as indicated by the shaded blue arrow) is from the right atrium and right ventricle through an atrial septal defect to the left side of the heart.
  • Blood can reach the pulmonary arteries only through a patent ductus arteriosus.
  • 10% of Congenital Heart Disease
  • Unequal division of trunks causes cusps to fuse to form a dome with a narrow/non-existent lumen.
  • Heart-lung transplantation may be the only therapy.

ICD-10

LInks: Search PubMed

Total Anomalous Pulmonary Venous Connection

Total Anomalous Pulmonary Venous Connection.jpg Total Anomalous Pulmonary Venous Connection (TAPVC) or Total Anomalous Pulmonary Venous Return (TAPVR) occurs when pulmonary veins connect to the right atrium (RA) and not the left atrium (LA). This abnormal connection returns oxygenated pulmonary blood from the lungs back to the right atrium or a vein flowing into the right atrium.
  • < 4% of Congenital Heart Disease
  • more common in females
  • Total or partial lack of connection of the pulmonary veins with LA.
  • They open into RA, one of the systemic veins or both.
  • The overloaded pulmonary circuit leads to cyanosis, tachypnoea and dyspnoea.
  • Treatment is via surgical redirection

ICD-10

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Complete Atrioventricular Canal

Complete atrioventricular canal.jpg
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Partial Anomalous Pulmonary Venous Drainage

Partial Anomalous Pulmonary Venous Drainage.jpg
  • < 4% of Congenital Heart Disease
  • more common in females
  • Total or partial lack of connection of the pulmonary veins with left atria (LA).
  • They open into right atria (RA), one of the systemic veins or both.
  • The overloaded pulmonary circuit leads to cyanosis, tachypnoea and dyspnoea.
  • Treatment is via surgical redirection

ICD-10

LInks: Search PubMed | PMID 22119121 | PMID 12652510

Aortic Stenosis

Aortic Stenosis.jpg
  • 7% of Congenital Heart Disease
  • Persistence of tissue that normally degenerates.
  • Results in left ventricle hypertrophy, heart murmurs.

ICD-10

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Pulmonary Stenosis

Pulmonary Stenosis.jpg
  • 10% of Congenital Heart Disease
  • Unequal division of trunks causes cusps to fuse to form a dome with a narrow/non-existent lumen.
  • Heart-lung transplantation may be the only therapy.

ICD-10 Q25.6 Stenosis of pulmonary artery Supravalvular pulmonary stenosis

LInks: Search PubMed

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a postnatal cardiac abnormality with left ventricular hypertrophy following pre-hypertrophic crypts, abnormal mitral leaflets and trabeculae. This heart anomaly is due to mutations in the sarcomeric protein genes, most commonly myosin-binding protein C (MYBPC3).

Blood Disorders

Sickle Cell Anemia

People who have this form of sickle cell disease inherit two sickle cell genes (“S”), one from each parent. This is commonly called “sickle cell anemia”, and is usually the most severe form of the disease. The name comes from the "sickle" shape of the RBC compared to the normal "donut" shape.


The scanning electron micrograph (SEM) on the right shows the ultrastructural morphology of a sickle cell RBC found in a blood specimen of an 18 year old female patient with sickle cell anemia, (HbSS).

Sickle cell RBC SEM01.jpg

Sickle cell RBC (Image CDC)

Thalassemia

Thalassemia is a group of inherited (genetic) blood disorders most frequently in people of Italian, Greek, Middle Eastern, Southern Asian and African Ancestry. The most severe form of alpha thalassemia, affecting mainly people of Southeast Asian, Chinese and Filipino ancestry, results in fetal or newborn death.


The two main types of thalassemia are called "alpha" and "beta," depending on which part of an oxygen-carrying protein in the red blood cells is lacking. Both types of thalassemia are inherited in the same manner. A child who inherits one mutated gene is a carrier, which is sometimes called "thalassemia trait." Most carriers lead completely normal, healthy lives.


Links: Blood Development | Medline Plus - sickle cell anemia | Medline Plus - thalassemia

Statistics

Australia

Abnormal81-92-heart.png

Data shown as a percentage of all major abnormalities based upon published statistics using the same groupings as Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352.

Belgium

Congenital heart disease in 111 225 births in Belgium 2008 study[12]:

  • 921 children with congenital heart disease (birth prevalence of 8.3 per 1000).
  • 33% ventricular septal defects most frequently occurring condition
  • 18% ostium secundum atrial septal defects
  • 10% pulmonary valve abnormalities
  • 39% had either cardiosurgical operation or catheter intervention.
  • 4% of the children died (higher in univentricular physiology, pulmonary atresia with VSD, left ventricle outflow obstruction and tetralogy of Fallot).


South America

Paediatric and congenital heart disease in South America: an overview.[13]

  • Ventricular septal defects - Surgical mortality with repair in infancy, mainly in the muscular septum, probably slightly higher in South America than in North America and Europe.
  • Secundum atrial septal defects - trans-catheter closure is the preferred method of treating most patients.
  • Pulmonary valve stenosis and atresia with intact ventricular septum - balloon pulmonary valvuloplasty for PVS.
  • Aortic stenosis - balloon valvuloplasty.
  • Coarctation of the aorta - children balloon angioplasty, adolescents and adults a trend towards the use of bare and covered stents.
  • Tetralogy of Fallot - patients with severe hypoxaemia have a modified Blalock–Taussig shunt.

USA

"Baltimore-Washington Infant Study data on live-born cases and controls (1981-1989) was reanalyzed for potential environmental and genetic risk-factor associations in complete atrioventricular septal defects AVSD (n = 213), with separate comparisons to the atrial (n = 75) and the ventricular (n = 32) forms of partial AVSD. ...Maternal diabetes constituted a potentially preventable risk factor for the most severe, complete form of AVSD." [2]

References

  1. Kirsty Tanner, Nilofer Sabrine, Christopher Wren Cardiovascular malformations among preterm infants. Pediatrics: 2005, 116(6);e833-8 PubMed 16322141
  2. 2.0 2.1 C A Loffredo, J Hirata, P D Wilson, C Ferencz, I W Lurie Atrioventricular septal defects: possible etiologic differences between complete and partial defects. Teratology: 2001, 63(2);87-93 PubMed 11241431
  3. 3.0 3.1 Rodney C G Franklin, Jeffrey Phillip Jacobs, Otto N Krogmann, Marie J Béland, Vera D Aiello, Steven D Colan, Martin J Elliott, J William Gaynor, Hiromi Kurosawa, Bohdan Maruszewski, Giovanni Stellin, Christo I Tchervenkov, Henry L Walters Iii, Paul Weinberg, Robert H Anderson Nomenclature for congenital and paediatric cardiac disease: historical perspectives and The International Pediatric and Congenital Cardiac Code. Cardiol Young: 2008, 18 Suppl 2;70-80 PubMed 19063777
  4. 4.0 4.1 Jorge M Giroud, Jeffrey P Jacobs, Diane Spicer, Carl Backer, Gerard R Martin, Rodney C G Franklin, Marie J Béland, Otto N Krogmann, Vera D Aiello, Steven D Colan, Allen D Everett, J William Gaynor, Hiromi Kurosawa, Bohdan Maruszewski, Giovanni Stellin, Christo I Tchervenkov, Henry L Walters, Paul Weinberg, Robert H Anderson, Martin J Elliott Report from the international society for nomenclature of paediatric and congenital heart disease: creation of a visual encyclopedia illustrating the terms and definitions of the international pediatric and congenital cardiac code. World J Pediatr Congenit Heart Surg: 2010, 1(3);300-13 PubMed 23804886
  5. Jun-Yi Zhu, Yulong Fu, Margaret Nettleton, Adam Richman, Zhe Han High throughput in vivo functional validation of candidate congenital heart disease genes in Drosophila. Elife: 2017, 6; PubMed 28084990 eLife
  6. Ariel B Rydeen, Joshua S Waxman Cyp26 Enzymes Facilitate Second Heart Field Progenitor Addition and Maintenance of Ventricular Integrity. PLoS Biol.: 2016, 14(11);e2000504 PubMed 27893754
  7. Katie E Best, Judith Rankin Long-Term Survival of Individuals Born With Congenital Heart Disease: A Systematic Review and Meta-Analysis. J Am Heart Assoc: 2016, 5(6); PubMed 27312802
  8. Toshiharu Miyake, Tohru Shinohara, Tomohiro Inoue, Satoshi Marutani, Tsukasa Takemura Spontaneous closure of muscular trabecular ventricular septal defect: comparison of defect positions. Acta Paediatr.: 2011, 100(10);e158-62 PubMed 21517965
  9. Nikhil Pendse, Sanjeev Gupta, Mohammed Abid Geelani, Harpreet Singh Minhas, Saket Agarwal, Akhlesh Tomar, Amit Banerjee Repair of atrial septal defects on the perfused beating heart. Tex Heart Inst J: 2009, 36(5);425-7 PubMed 19876418
  10. 10.0 10.1 Fabíola Sawaguchi Faig-Leite, Horácio Faig-Leite Anatomy of a dextrocardia case with situs solitus. Arq. Bras. Cardiol.: 2008, 91(6);e64-6 PubMed 19142355 | Arq Bras Cardiol.
  11. Damien Kenny, Ziyad M Hijazi Coarctation of the aorta: from fetal life to adulthood. Cardiol J: 2011, 18(5);487-95 PubMed 21947983 | PDF
  12. Philip Moons, Thierry Sluysmans, Daniel De Wolf, Martial Massin, Bert Suys, Abraham Benatar, Marc Gewillig Congenital heart disease in 111 225 births in Belgium: birth prevalence, treatment and survival in the 21st century. Acta Paediatr.: 2009, 98(3);472-7 PubMed 19046347
  13. C A C Pedra, J Haddad, S F Pedra, A Peirone, C B Pilla, J A Marin-Neto Paediatric and congenital heart disease in South America: an overview. Heart: 2009, 95(17);1385-92 PubMed 19174420

Articles

Srinivasan Dinesh Kumar, S Thameem Dheen, Samuel Sam Wah Tay Maternal diabetes induces congenital heart defects in mice by altering the expression of genes involved in cardiovascular development. Cardiovasc Diabetol: 2007, 6;34 PubMed 17967198


Search Pubmed

Search Pubmed: Cardiovascular System Abnormalities

5 Most Recent

Note - This sub-heading shows an automated computer PubMed search using the listed sub-heading term. References appear in this list based upon the date of the actual page viewing. Therefore the list of references do not reflect any editorial selection of material based on content or relevance. In comparison, references listed on the content page and discussion page (under the publication year sub-headings) do include editorial selection based upon relevance and availability. (More? Pubmed Most Recent)

Ventricular Septal Defect

Charanjit S Rihal, Joseph J Maleszewski New Insights Into an Old Problem. JACC Cardiovasc Interv: 2017, 10(12);1244-1246 PubMed 28641845

Mark C K Hamilton, Jonathan C L Rodrigues, Robin P Martin, Nathan E Manghat, Mark S Turner The In Vivo Morphology of Post-Infarct Ventricular Septal Defect and the Implications for Closure. JACC Cardiovasc Interv: 2017, 10(12);1233-1243 PubMed 28641844

Florian Rey, Fabio Rigamonti, Jawad Chaara, Hajo Müller, Pascal Meier, Marco Roffi, Stéphane Noble [Post-myocardial infarction ventricular septal defect]. [Communication interventriculaire postinfarctus du myocarde : mise au point.] Rev Med Suisse: 2017, 13(564);1088-1093 PubMed 28639771

Young-Sun Cho, So-Eun Park, Soo-Kyung Hong, Na-Yeong Jeong, Eun-Young Choi The natural history of fetal diagnosed isolated ventricular septal defect. Prenat. Diagn.: 2017; PubMed 28639332

Ryan S D'souza, Luisa Mestroni, Matthew R G Taylor Danon disease for the cardiologist: case report and review of the literature. J Community Hosp Intern Med Perspect: 2017, 7(2);107-114 PubMed 28638575


Atrial Septal Defect

Tao Zhou, Jianjun Zhang, Yi Luo, Yuan Liu, Sy Zhuang, Feng Xue, Longzhi Han, Qiang Xia Clinical Characteristics and Outcome of Liver Transplantation for Alagille Syndrome in Children. J Dig Dis: 2017; PubMed 28644566

Aaron Clem, Sami Awadallah, Zahid Amin Safety, Feasibility, Results, and Economic Impact of Common Interventional Procedures in a Low-Volume Region of the United States. Pediatr Cardiol: 2017; PubMed 28639149

Ryan S D'souza, Luisa Mestroni, Matthew R G Taylor Danon disease for the cardiologist: case report and review of the literature. J Community Hosp Intern Med Perspect: 2017, 7(2);107-114 PubMed 28638575

Zulal Ozkurt, Esra Cinar Tanriverdi Global Alert: Zika Virus-an Emerging Arbovirus. Eurasian J Med: 2017, 49(2);142-147 PubMed 28638259

Jeong Yoon Jang, Ran Heo, Min Soo Cho, Jaeseok Bae, Jung Ae Hong, Sahmin Lee, Jung-Min Ahn, Duk-Woo Park, Dae-Hee Kim, Duk-Hyun Kang, Jae-Kwan Song, Jong-Min Song Efficacy of 3D transoesophageal echocardiography for transcatheter device closure of atrial septal defect without balloon sizing. Eur Heart J Cardiovasc Imaging: 2017; PubMed 28633478


Patent Ductus Arteriosus

Aaron Clem, Sami Awadallah, Zahid Amin Safety, Feasibility, Results, and Economic Impact of Common Interventional Procedures in a Low-Volume Region of the United States. Pediatr Cardiol: 2017; PubMed 28639149

Amnon Zung, Rachel Bier Palmon, Agneta Golan, Mara Troitzky, Smadar Eventov-Friedman, Ronella Marom, Rimona Keidar, Neri Kats, Shlomo Almashanu, Orna Flidel-Rimon Risk Factors for the Development of Delayed TSH Elevation in Neonatal Intensive Care Unit (NICU) Newborns. J. Clin. Endocrinol. Metab.: 2017; PubMed 28637222

Emelina Stambolliu, Myrsini Ioakeim-Ioannidou, Kimonas Kontokostas, Maria Dakoutrou, Antonis A Kousoulis The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports. J. Child Neurol.: 2017;883073817712589 PubMed 28635420

Tania Tamayo-Espinosa, Julio Erdmenger-Orellana, Rosario Becerra-Becerra, Norma Balderrabano-Saucedo, Begoña Segura-Standford [Right-side aortic arch with aberrant left subclavian artery and Kommerell's diverticulum. A cause of vascular ring]. [Arco aórtico derecho con subclavia izquierda aberrante y divertículo de Kommerell. Una causa de anillo vascular.] Arch Cardiol Mex: 2017; PubMed 28625795

Jan Hau Lee, Rachel G Greenberg, Bin H Quek, Reese H Clark, Matthew M Laughon, P Brian Smith, Christoph P Hornik Association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants. Cardiol Young: 2017;1-8 PubMed 28625190


Tetralogy of Fallot

Yu Wang, Miao Fan, Faiza Amber Siddiqui, Meilian Wang, Wei Sun, Xue Sun, Wenjia Lei, Ying Zhang Prenatal screening of fetal ventriculoarterial connections: benefits of 4D technique in fetal heart imaging. Cardiovasc Ultrasound: 2017, 15(1);17 PubMed 28645293

Kristofer Skoglund, Gunnar Svensson, Ulf Thilén, Mikael Dellborg, Peter Eriksson Long-term outcome after right ventricle to pulmonary artery conduit surgery and reintervention. Scand. Cardiovasc. J.: 2017;1-8 PubMed 28645241

Elena Bernardis, Yong Zhang, Ender Konukoglu, Yangming Ou, Harold Javitz, Leon Axel, Dimitris N Metaxas, Benoit Desjardins, Kilian M Pohl eCurves: A Temporal Shape Encoding. IEEE Trans Biomed Eng: 2017; PubMed 28641243

Guillermo Larios, Mark K Friedberg Imaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiography. Curr. Opin. Cardiol.: 2017; PubMed 28639972

A Yu Omelchenko, I A Soynov, Yu N Gorbatykh, Yu Yu Kulyabin, A V Gorbatykh, N R Nichay, A V Voitov, A V Bogochev-Prokophiev [Right ventricular dysfunction after tetralogy of Fallot repair: are all questions resolved?] [Disfunktsiia pravogo zheludochka u patsientov posle korrektsii tetrady Fallo: vse li voprosy resheny?] Khirurgiia (Mosk): 2017, (6);84-90 PubMed 28638021


Terms

Cardiovascular Terms  
Cardiovascular System Development See also Heart terms
  • angioblast - the stem cells in blood islands generating endothelial cells which will form the walls of both arteries and veins. (More? Blood Vessel)
  • angiogenesis - the formation of new blood vessels from pre-existing vessels following from vasculogenesis in the embryo. (More? Blood Vessel)
  • anlage (German, anlage = primordium) structure or cells which will form a future more developed or differentiated adult structure.
  • blood islands - earliest sites of blood vessel and blood cell formation, seen mainly on yolk sac chorion.
  • cardinal veins - paired main systemic veins of early embryo, anterior, common, posterior.
  • cardiogenic region - region above prechordal plate in mesoderm where heart tube initially forms.
  • ectoderm - the layer (of the 3 germ cell layers) which form the nervous system from the neural tube and neural crest and also generates the epithelia covering the embryo.
  • endoderm - the layer (of the 3 germ cell layers) which form the epithelial lining of the gastrointestinal tract (GIT) and accessory organs of GIT in the embryo.
  • endocardium - lines the heart. Epithelial tissue lining the inner surface of heart chambers and valves.
  • endothelial cells - single layer of cells closest to lumen that line blood vessels.
  • extraembryonic mesoderm - mesoderm lying outside the trilaminar embryonic disc covering the yolk sac, lining the chorionic sac and forming the connecting stalk. Contributes to placental villi development.
  • haemocytoblasts - stem cells for embryonic blood cell formation.
  • anastomose - to connect or join by a connection (anastomosis) between tubular structures.
  • chorionic villi - the finger-like extensions which are the functional region of the placental barrier and maternal/fetal exchange. Develop from week 2 onward as: primary, secondary, tertiary villi.
  • estrogens - support the maternal endometrium.
  • growth factor - usually a protein or peptide that will bind a cell membrane receptor and then activates an intracellular signaling pathway. The function of the pathway will be to alter the cell directly or indirectly by changing gene expression. (eg VEGF, shh)
  • maternal decidua - region of uterine endometrium where blastocyst implants. undergoes modification following implantation, decidual reaction.
  • maternal sinusoids - placental spaces around chorionic villi that are filled with maternal blood. Closest maternal/fetal exchange site.
  • mesoderm - the middle layer of the 3 germ cell layers of the embryo. Mesoderm outside the embryo and covering the amnion, yolk and chorion sacs is extraembryonic mesoderm.
  • myocardium - muscular wall of the heart. Thickest layer formed by spirally arranged cardiac muscle cells.
  • pericardium - covers the heart. Formed by 3 layers consisting of a fibrous pericardium and a double layered serous pericardium (parietal layer and visceral epicardium layer).
  • pericytes - (Rouget cells) cells located at the abluminal surface of microvessels close to endothelial cells, mainly found associated with CNS vessels and involved in vessel formation, remodeling and stabilization.
  • pharyngeal arches (=branchial arches, Gk. gill) series of cranial folds that form most structures of the head and neck. Six arches form but only 4 form any structures. Each arch has a pouch, membrane and groove.
  • placenta - (Greek, plakuos = flat cake) refers to the discoid shape of the placenta, embryonic (villous chorion)/maternal organ (decidua basalis)
  • placental veins - paired initially then only left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus).
  • protein hormone - usually a protein distributed in the blood that binds to membrane receptors on target cells in different tissues. Do not easliy cross placental barrier.
  • sinus venosus - cavity into which all major embryonic paired veins supply (vitelline, placental, cardinal).
* splanchnic mesoderm - portion of lateral plate mesoderm closest to the endoderm when coelom forms. 
  • steroid hormone - lipid soluble hormone that easily crosses membranes to bind receptors in cytoplasm or nucleus of target cells. Hormone+Receptor then binds DNA activating or suppressing gene transcription. Easliy cross placental barrier.
  • syncitiotrophoblast extraembryonic cells of trophoblastic shell surrounding embryo, outside the cytotrophoblast layer, involved with implantation of the blastocyst by eroding extracellular matrix surrounding maternal endometrial cells at site of implantation, also contribute to villi. (dark staining, multinucleated).
  • truncus arteriosus - an embryological heart outflow structure, that forms in early cardiac development and will later divides into the pulmonary artery and aorta. Term is also used clinically to describe the malformation where only one artery arises from the heart and forms the aorta and pulmonary artery.
  • vascular endothelial growth factor - (VEGF) A secreted protein growth factor family, which stimulates the proliferation of vasular endotheial cells and therefore blood vessel growth. VEGF's have several roles in embryonic development. The VEGF family has 7 members (VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, VEGF-F, and PlGF) that have a common VEGF homology domain. PIGF is the placental growth factor. They act through 3 VEGF tyrosine kinase membrane receptors (VEGFR-1 to 3) with seven immunoglobulin-like domains in the extracellular domain, a single transmembrane region, and an intracellular tyrosine kinase sequence.
  • vasculogenesis - the formation of new blood vessels from mesoderm forming the endothelium. Compared to angiogenesis that is the process of blood vessel formation from pre-existing vessels.
  • vitelline blood vessels - blood vessels associated with the yolk sac.
  • waste products - products of cellular metabolism and cellular debris, e.g.- urea, uric acid, bilirubin.
Other Terms Lists  
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Cite this page: Hill, M.A. 2017 Embryology Cardiovascular System - Abnormalities. Retrieved June 26, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Cardiovascular_System_-_Abnormalities

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