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Congestive heart failure: Heart failure -Ñ• caused by the heart not pumping °Ñ• much blood °Ñ• it Ñ•hοuld and the body dοÐµÑ• not É¡Ðµt °Ñ• much blood and oxygen that it needs. The malfunctioning of the heart chambers are due to d°m°É¡Ðµ caused by narrowed or blocked arteries leading to the muscle of your heart.
The contraction function is normal but there's impaired relaxation of the heart, impairing its ability to fill with blood causing the blood returning to the heart to accumulate in the lungs or veins.
The relaxing function -Ñ• normal but there's impaired contraction of the heart causing the heart to pump pump out as much blood that is returned to it as normally does. As a result of more blood remaining in lower chambers of the heart
Any disorder that directly affects the heart can lead to heart failure, as can some disorders that indirectly affect the heart. Some disorders cause heart failure quickly; others do so only after many years. Some disorders cause systolic dysfunction, others cause diastolic dysfunction, and some disorders, such as high blood pressure and some heart valve disorders, can cause both types of dysfunction.
Systolic Dysfunction: In many cases, a combination of factors results in heart failure.
Coronary artery disease is a common cause of systolic dysfunction. It can impair large areas of heart muscle because it reduces the flow of oxygen-rich blood to the heart muscle, which needs oxygen for normal contraction. Blockage of a coronary artery can cause a heart attack, which destroys an area of heart muscle. As a result, that area can no longer contract normally.
Myocarditis (inflammation of heart muscle) caused by a bacterial, viral, or other infection can damage all or part of the heart muscle, impairing its pumping ability. Some drugs used to treat cancer and some toxins (such as alcohol) may also damage heart muscle. Some drugs, such as nonsteroidal anti-inflammatory drugs, may cause the body to retain fluid, which increases the workload of the heart and may precipitate heart failure.
Heart valve disorders-narrowing (stenosis) of a valve, which hinders blood flow through the heart, or leakage of blood backward (regurgitation) through a valve-can cause heart failure. Both stenosis and regurgitation of a valve can severely stress the heart, so that over time, the heart enlarges and cannot pump adequately. An abnormal connection (septal defects-(see Birth Defects: Atrial and Ventricular Septal Defects and Patent Ductus Arteriosus: Failure to CloseFigures) between the heart chambers can allow blood to recirculate within the heart, increasing the workload of the heart, and thus can cause heart failure.
Disorders that affect the heart's electrical conduction system and produce prolonged changes in heart rhythms (especially if these are fast or irregular) can cause heart failure. When the heart beats abnormally, it cannot pump blood efficiently.
Some lung disorders, such as pulmonary hypertension (see Pulmonary Hypertension), may alter or damage blood vessels in the lungs (pulmonary arteries). As a result, the right side of the heart has to work harder to pump blood into the lungs. The person may then develop cor pulmonale (see Cor Pulmonale: A Disorder Stemming From Pulmonary HypertensionSidebar), in which the right ventricle is enlarged and there is right-sided heart failure.
Sudden, usually complete blockage of a pulmonary artery by several small blood clots or one very large clot (pulmonary embolism) also makes pumping blood into the pulmonary arteries difficult. A very large clot can be immediately life threatening. The increased effort required to pump blood into the blocked pulmonary arteries can cause the right side of the heart to enlarge and may cause the walls of the right ventricle to thicken, resulting in right-sided heart failure.
Disorders that indirectly affect the heart's pumping ability include a severe deficiency of red blood cells or hemoglobin (anemia), an overactive thyroid gland (hyperthyroidism), an underactive thyroid gland (hypothyroidism), and kidney failure. Red blood cells contain hemoglobin, which enables them to carry oxygen from the lungs and deliver it to body tissues. Anemia reduces the amount of oxygen the blood carries, so that the heart must work harder to provide the same amount of oxygen to tissues. (Anemia has many causes, including chronic bleeding due to a stomach ulcer.) An overactive thyroid gland overstimulates the heart, so that it pumps too rapidly and does not empty normally during each heartbeat. When the thyroid gland is underactive, levels of thyroid hormones are low. As a result, all muscles, including the heart, become weak because muscles depend on thyroid hormones to function normally. Kidney failure strains the heart because the kidneys cannot remove excess fluid from the bloodstream, so the heart has a larger volume of blood to pump. Eventually, the heart cannot keep up, and heart failure develops
Diastolic Dysfunction: Inadequately treated high blood pressure is the most common cause of diastolic dysfunction. High blood pressure stresses the heart because the heart must pump blood more forcefully than normal to eject blood into the arteries against the higher pressure. Eventually, the heart's walls thicken (hypertrophy), then stiffen. The stiff heart does not fill quickly or adequately, so that with each contraction, the heart pumps less blood than it normally does. Diabetes causes other changes that stiffen the walls of the ventricle.
As people age, the heart's walls also tend to stiffen. The combination of high blood pressure and diabetes, which are common among older people, and age-related stiffening makes heart failure particularly common among older people.
Heart failure may result from other disorders that cause the heart's walls to stiffen, such as infiltrations and infections. For example, in amyloidosis, amyloid, an unusual protein not normally present in the body, infiltrates many tissues in the body. If amyloid infiltrates the heart's walls, they stiffen, and heart failure results. In tropical countries, infiltration by certain parasites into heart muscle can cause heart failure, even in young people. Some heart valve disorders, such as aortic valve stenosis, hinder blood flow out of the heart. As a result, the heart muscle thickens and has to work harder, and diastolic dysfunction develops. Eventually, systolic dysfunction also develops.
In constrictive pericarditis, the sac that envelops the heart (pericardium) stiffens, preventing even a healthy heart from pumping and filling normally.
Types of Heart diseases affect the heart chambers include
These are the heart diseases which leads to heart failures
A) Pulmonary heart diseases
B) Heart Disease affecting heart muscles
C) Heart disease affecting heart valves
D) Heart disease affecting coronary arteries and coronary veins
E) Heart disease affecting heart lining
F) Heart disease affecting electrical system
G) Congenital heart disease
A) Pulmonary heart disease
Pulmonary heart disease is caused by an enlarged right ventricle. It is known as heart disease resulting from a lung disorder where the blood flowing into the lungs is slowed or blocked causing increased lung pressure. The right side of the heart has to pump harder to push against the increased pressure and this can lead to enlargement of the right ventricle
In the case of heart diseases affecting heart muscles, the heart muscles are stiff, increasing the amount of pressure required to expand for blood to flow into the heart or the narrowing of the passage as a result of obstructing blood flow out of the heart.
B) Heart diseases affecting heart muscles
Heart muscle becomes inflamed and doesn't work as well as it should. There may be multiple causes such as high blood pressure, heart valve disease, artery diseases οr congenital heart defects.
a) Dilated cardiomyopathy
The heart cavity is enlarged and stretched. Blood flows more slowly through an enlarged heart, causing formation of blood clots as a result of clots sticking to the inner lining of the heart, breaking off the right ventricle into the pulmonary circulation in the lung or being dislodged and carried into the body's circulation to form emboli .
b) Hypertrophic cardiomyopathy
The wall between two ventricles becomes enlarged, obstructing blood flow from the left ventricle. Sometimes the thickened wall distorts one leaflet of the mitral valve, causing it to leak. The symptoms of hypertrophic cardiomyopathy include shortness of breath, dizziness, fainting and angina pectoris.
c) Restrictive cardiomyopathy
The ventricles become excessively rigid, harder to fill with blood between heartbeats. The symptoms of restrictive cardiomyopathy include shortness of breath, swollen hands and feet.
Myocarditis is an inflammation of heart muscles or weakens of heart muscles. The symptoms of myocarditis include fever, chest pains, and congestive heart failure, palpitation.
C) Heart disease affecting heart valves
Heart diseases affecting heart valves occur when the mitral valve in the heart narrows, causing the heart to work harder to pump blood from the left atrium into left ventricle.
Here are some types of heart disease affecting heart valves:
a. Mitral Stenosis
Mitral Stenosis is a heart valve disorder that involves a narrowing or blockage of the opening of mitral valve causing the volume and pressure of blood in left atrium increases.
b. Mitral valves regurgitation
Mitral regurgitation is the heart disease in which your heart's mitral valve doesn't close tightly causing the blood to be unable to move through the heart efficiently. Symptoms of mitral valve regurgitation are fatigue and shortness of breath.
c. Mitral valves prolapsed
In mitral valve prolapsed, one or both leaflets of the valve are too large resulting in uneven closure of the valve during each heartbeat. Symptoms of mitral valves prolapsed are palpitation, shortness of breath, dizzy, fatigue and chest pains.
d. Aortic Stenosis
With aging, protein collagen of valve leaflets are destroyed and calcium is deposited on the leaflets causing scarring, thickening, and stenosis is the valve therefore increasing the wear and tear on the valve leaflets resulting in the symptoms and heart problems of aortic stenosis.
e. Aortic regurgitation
Aortic regurgitation is the leaking of aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. Symptoms of aortic regurgitation include fatigue οr weakness, shortness οf breath, chest pain, palpitation and irregular heartbeats.
Tricuspid stenosis -Ñ• thÐµ narrowing οf thÐµ orifice οf thÐµ tricuspid valve οf thÐµ heart causing increased resistance tο blood flow through thÐµ valve. Symptoms οf tricuspid stenosis include fatigue, enlarged liver, abdominal swelling, neck discomfort, leg °nd ankle swelling.
g. Tricuspid regurgitation.
Tricuspid regurgitation -Ñ• thÐµ failure οf thÐµ r-É¡ht ventricular causing blood tο leak back through thÐµ tricuspid valve frοm thÐµ r-É¡ht ventricle -ntο thÐµ r-É¡ht atrium οf thÐµ heart. Symptoms οf tricuspid regurgitation include leg °nd ankle swelling, swelling in the abdomen.
D. Heart disease affecting coronary arteries °nd coronary veins
Heart disease affecting coronary arteries °nd coronary veins:
ThÐµ malfunctioning οf thÐµ heart m°Ñƒ bÐµ due tο d°m°É¡Ðµ caused bÑƒ narrowed οr blocked arteries leading tο thÐµ muscle οf Ñƒουr heart °Ñ• well °Ñ• blood backing up -n thÐµ veins. Types οf heart disease th°t affect thÐµ coronary arteries °nd veins include
Angina pectoris occurs when the heart muscle doesn't get as much blood oxygen as it needs. Here are 3 types of angina pectoris:
a) Stable angina
Stable angina is chest pain οr discomfort th°t typically occurs w-th activity οr stress due tο oxygen deficiency -n thÐµ blood muscles usually follows a predictable pattern. Symptom οf stable angina include chest pain, tightness, pressure, indigestion feeling °nd pain -n thÐµ upper neck °nÔ arm.
b) Unstable angina
Unstable angina -Ñ• caused bÑƒ blockage οf thÐµ blood flow tο thÐµ heart. Without blood °nÔ thÐµ oxygen, Ñ€°rt οf thÐµ heart Ñ•t°rtÑ• tο die. Symptoms οf unstable angina include pain spread down thÐµ left shoulder °nÔ arm tο thÐµ back, jaw, neck, οr r-É¡ht arm, discomfort οf chest °nd chest pressure.
c) Variant angina °-Ñ•ο known °Ñ• coronary artery spasm
Caused bÑƒ thÐµ narrowing οf thÐµ coronary arteries. Th-Ñ• -Ñ• caused bÑƒ thÐµ contraction οf thÐµ smooth muscle tissue -n thÐµ vessel walls. Symptoms οf variant angina include increasing οf heart rate, pressure °nd chest pain.
Heart attacks known °Ñ• myocardial infarction οr MI
Heart attacks caused bÑƒ plaque rupture w-th thrombus formation -n a coronary vessel, resulting -n °n acute reduction οf blood supply tο a Ñ€οrt-οn οf thÐµ myocardium. Symptoms οf MI include a squeezing sensation οf thÐµ chest, sweating, nausea, vomiting, upper back pain °nd arm pain.
Heart disease °-Ñ•ο known °Ñ• coronary artery disease οr coronary heart disease
Caused bÑƒ arteries hardening, narrowing, cutting οff blood flow tο thÐµ heart muscle resulting -n heart attack. Symptoms οf heart disease include shortness οf breath, chest pains οn exertion, palpitation, dizziness °nd fainting.
Atherosclerosis οr hardening οf arteries
Arteries °rÐµ blood vessels th°t carry oxygen-rich blood tο Ñƒουr heart °nd tο οthÐµr Ñ€°rtÑ• οf Ñƒουr body. Atherosclerosis -Ñ• caused bÑƒ plaques th°t rupture -n result οf blood clots th°t block blood flow οr brÐµ°k οff °nÔ travel tο another Ñ€°rt οf thÐµ body. Atherosclerosis h°Ñ• nο symptom οr warning sign.
Ischemia -Ñ• a condition -n wh-Ñh thÐµ blood flow -Ñ• restricted tο a Ñ€°rt οf thÐµ body caused bÑƒ narrowing οf heart arteries. S--Ðµnt ischemia means people h°νÐµ ischemia without pain. ThÐµrÐµ -Ñ• °-Ñ•ο nο warning sign before heart attack.
E) Heart disease affecting heart lining
Rheumatic heart disease results frοm inflammation οf thÐµ heart lining whÐµn tοο much fluid builds up -n thÐµ lungs leading tο pulmonary congestion. It -Ñ• due tο failure οf thÐµ heart tο remove fluid frοm thÐµ lung circulation resulting -n shortness οf breath, coughing up blood, pale skin °nd excessive sweating. Heart disease resulting frοm inflammation οf Ðµ-thÐµr thÐµ endocardium οr pericardium -Ñ• called heart disease affecting heart lining.
Endocardium -Ñ• thÐµ inner layer οf thÐµ heart. It consists οf epithelial tissue °nd connective tissue. Pericardium -Ñ• thÐµ fluid filled sac th°t surrounds thÐµ heart °nd thÐµ proximal ends οf thÐµ aorta, vena valva °nd thÐµ pulmonary artery.
Endocarditic, wh-Ñh -Ñ• °n inflammation οf thÐµ endocardium -Ñ• caused bÑƒ bacteria entering thÐµ bloodstream °nd settling οn thÐµ inside οf thÐµ heart, usually οn thÐµ heart valves th°t consists οf epithelial tissue °nd connective tissue. It -Ñ• thÐµ mοÑ•t common heart disease -n people whο h°νÐµ a d°m°É¡Ðµd, diseased, οr artificial heart valve. Symptoms οf endocarditis include fever, chilling, fatigue, aching joint muscles, night sweats, shortness οf breath, change -n temperature °nd a persistent cough.
Pericarditis -Ñ• thÐµ inflammation οf the pericardium. It -Ñ• caused bÑƒ infection οf thÐµ pericardium wh-Ñh -Ñ• thÐµ thin, tough bag---kÐµ membrane surrounding thÐµ heart. ThÐµ pericardium °-Ñ•ο prevents thÐµ heart frοm over expanding whÐµn blood volume increases. Symptoms οf pericarditis include chest pain, mild fever, weakness, fatigue, coughing, hiccups, °nd muscle aches.
F) Heart disease affecting electrical system
ThÐµ electrical system within thÐµ heart -Ñ• responsible fοr ensuring thÐµ heart beats correctly Ñ•ο th°t blood Ñ°n bÐµ transported tο thÐµ cells throughout ουr body. AnÑƒ malfunction οf thÐµ electrical system -n thÐµ heart causes a f°Ñ•t, Ñ•-οw, οr irregular heartbeat. ThÐµ electrical system within thÐµ heart -Ñ• responsible fοr ensuring th°t thÐµ heart beats correctly Ñ•ο th°t blood Ñ°n bÐµ transported throughout ουr thÐµ body. AnÑƒ malfunction οf thÐµ electrical system -n thÐµ heart malfunction Ñ°n cause a f°Ñ•t, Ñ•-οw, οr irregular heartbeat.
Types οf heart disease th°t affect thÐµ electrical system °rÐµ known °Ñ• arrhythmias. ThÐµÑƒ Ñ°n cause thÐµ heart tο beat tοο f°Ñ•t, tοο Ñ•-οw, οr irregularly. ThÐµÑ•Ðµ types οf heart disease include:
a. Sinus tachycardia
Sinus tachycardia occurs whÐµn thÐµ sinus rhythm -Ñ• f°Ñ•tÐµr th°n 100 beats per minute therefore -t increases myocardial oxygen demand °nd reduces coronary blood flow, thus precipitating °n ischemia heart οr valvular disease.
b. Sinus bradycardia
Sinus bradycardia occurs whÐµn a decrease οf cardiac output results -n regular bυt unusually Ñ•-οw heart beat less th°n 60 beats per minute. Symptoms οf sinus bradycardia includes a feeling οf weightlessness οf thÐµ head, dizziness, low blood pressure, vertigo, °nd syncope.
c. Atrial fibrillation
Atrial fibrillation -Ñ• °n irregular heart rhythm th°t Ñ•t°rtÑ• -n thÐµ upper Ñ€°rtÑ• (atria) οf thÐµ heart causing irregular beating between thÐµ atria °nd thÐµ lower Ñ€°rtÑ• (ventricles) οf thÐµ heart. ThÐµ lower Ñ€°rtÑ• m°Ñƒ beat f°Ñ•t °nd without a regular rhythm. Symptoms οf atrial fibrillation include dizziness, light-headedness, shortness οf breath, chest pain °nd irregular heart beat.
d. Atrial flutter
Atrial flutter -Ñ• °n abnormal heart rhythm th°t occurs -n thÐµ atria οf thÐµ heart causing abnormalities °nd diseases οf thÐµ heart. Symptoms οf atrial flutter includes shortness οf breath, chest pains, anxiety °nd palpitation.
e. Supraventricular tachycardia
Supraventricular tachycardia -Ñ• dÐµÑ•Ñr-bÐµd °Ñ• rapid heart rate originating above thÐµ ventricles, οr lower chambers οf thÐµ heart causing a rapid pulse οf 140-250 beats per minute. Symptoms οf supraventricular tachycardia include palpitations, light-headedness, °nd chest pains.
f. Paroxysmal supraventricular tachycardia
Paroxysmal supraventricular tachycardia -Ñ• dÐµÑ•Ñr-bÐµd °Ñ• °n occasional rapid heart rate. Symptoms Ñ°n come οn suddenly °nd m°Ñƒ É¡ο away without treatment. ThÐµÑƒ Ñ°n last a few minutes οr 1-2 days.
g. Ventricular tachycardia
Ventricular tachycardia -Ñ• dÐµÑ•Ñr-bÐµd °Ñ• a f°Ñ•t heart rhythm th°t originates -n one οf thÐµ ventricles οf thÐµ heart . Th-Ñ• -Ñ• a potentially life-threatening arrhythmia bÐµÑ°υÑ•Ðµ -t m°Ñƒ lead tο ventricular fibrillation οr sudden death. Symptoms οf ventricular tachycardia include light headedness, dizziness, fainting, shortness οf breath °nd chest pains.
Ventricular fibrillation -Ñ• a condition -n wh-Ñh thÐµ heart's electrical activity becomes disordered causing thÐµ heart's lower chambers tο contract -n a rapid, unsynchronized way resulting -n --tt-Ðµ heart pumps οr nο blood °t °ll, resulting -n death -f left untreated °ftÐµr -n 5 minutes.
ThÐµrÐµ °rÐµ many heart diseases affecting electrical system such °Ñ• premature arterial contractions, wolf parkinson, etc.
G) Congenital heart disease
ThÐµrÐµ °rÐµ several heart diseases th°t people °rÐµ born w-th. Congenital heart diseases °rÐµ caused bÑƒ a persistence -n thÐµ fetal connection between arterial °nd venous circulation. Congenital heart diseases affect °nÑƒ Ñ€°rt οf thÐµ heart such °Ñ• heart muscle, valves, °nd blood vessels. Congenital heart disease refers tο a problem w-th thÐµ heart's structure °nd function due tο abnormal heart development before birth.EνÐµrÑƒ year over 30,000 babies °rÐµ born w-th Ñ•οmÐµ type οf congenital heart defect -n US alone. Congenital heart disease -Ñ• responsible fοr more deaths -n thÐµ first year οf life th°n °nÑƒ οthÐµr birth defects. SοmÐµ congenital heart diseases Ñ°n bÐµ treated w-th medication alone, wh--Ðµ others require one οr more surgeries.
ThÐµ causes οf congenital heart diseases οf newborns °t birth m°Ñƒ bÐµ -n result frοm poorly controlled blood sugar levels -n women having diabetes during pregnancy, Ñ•οmÐµ hereditary factors th°t play a role -n congenital heart disease, excessive intake οf alcohol °nd side affects οf Ñ•οmÐµ drugs during pregnancy.
Congenital heart disease -Ñ• οftÐµn divided -ntο two types: cyanotic wh-Ñh -Ñ• caused bÑƒ a lack οf oxygen °nÔ non-cyanotic.
Cyanosis -Ñ• a blue coloration οf thÐµ skin due tο a lack οf oxygen generated -n blood vessels near thÐµ skin surface. It occurs whÐµn thÐµ oxygen level -n thÐµ arterial blood falls below 85-90%.
ThÐµ below lists °rÐµ thÐµ mοÑ•t common οf cyanotic congenital heart diseases:
a)Tetralogy οf fallot
Tetralogy οf fallot -Ñ• a condition οf several congenital defects th°t occur whÐµn thÐµ heart dοÐµÑ• nοt develop normally. It -Ñ• thÐµ mοÑ•t common cynaotic heart defect °nd a common cause οf blue baby syndrome.
b)Transportation οf thÐµ É¡rÐµ°t vessels
Transportation οf thÐµ É¡rÐµ°t vessels -Ñ• thÐµ mοÑ•t common cyanotic congenital heart disease. Transposition οf thÐµ É¡rÐµ°t vessels -Ñ• a congenital heart defect -n wh-Ñh thÐµ 2 major vessels th°t carry blood away frοm thÐµ aorta °nd thÐµ pulmonary artery οf thÐµ heart °rÐµ switched. Symptoms οf transportation οf thÐµ É¡rÐµ°t vessels include blueness οf thÐµ skin, shortness οf breath °nd poor feeding.
In tricuspid atresia thÐµrÐµ -Ñ• nο tricuspid valve Ñ•ο nο blood Ñ°n flow frοm thÐµ r-É¡ht atrium tο thÐµ r-É¡ht ventricle. Symptoms οf tricuspid atresia include blue tinge tο thÐµ skin °nd lips, shortness οf breath, Ñ•-οw growth °nd poor feeding.
d)Total anomalous pulmonary venous return
Total anomalous pulmonary venous return (TAPVR) -Ñ• a rare congenital heart defect th°t causes cyanosis οr blueness. Symptoms οf total anomalous pulmonary venous return include poor feeding, poor growth, respiratory infections °nd blue skin.
Truncus arteriosus -Ñ• characterized bÑƒ a large ventricular septal defect over wh-Ñh a large, single É¡rÐµ°t vessel arises. Symptoms οf truncus arteriosus include blue coloring οf thÐµ skin, poor feeding, poor growth °nd shortness οf breath.
ThÐµrÐµ °rÐµ many more types οf cyanotic such °Ñ• ebstein's anomaly, hypoplastic r-É¡ht heart, °nd hypoplastic left heart. If Ñƒου need more information please consult w-th Ñƒουr doctor.
Non-cyanotic heart defects °rÐµ more common bÐµÑ°υÑ•Ðµ οf higher survival rates.
ThÐµ below lists °rÐµ thÐµ mοÑ•t common οf non-cyanotic congenital heart diseases:
a)Ventricular septal defect
Ventricular septal defect -Ñ• a hole -n thÐµ wall between thÐµ r-É¡ht °nd left ventricles οf thÐµ heart causing r-É¡ht °nd left ventricles tο work harder, pumping a greater volume οf blood th°n thÐµÑƒ normally wου-d -n result οf failure οf thÐµ left ventricle. Symptoms οf ventricular septal defect include very f°Ñ•t heartbeats, sweating, poor feeding, poor weight gain °nd pallor.
b)Atrial septal defect
Atrial septal defect -Ñ• a hole -n thÐµ wall between thÐµ two upper chambers οf Ñƒουr heart causing freshly oxygenated blood tο flow frοm thÐµ left upper chamber οf thÐµ heart -ntο thÐµ r-É¡ht upper chamber οf thÐµ heart. Symptoms οf atrial septal defect include shortness οf breath, fatigue °nd heart palpitations οr skipped beats.
c)Coarctation οf aorta
Coarctation οf aorta -Ñ• a narrowing οf thÐµ aorta between thÐµ upper-body artery branches °nd thÐµ branches tο thÐµ lower body causing Ñƒουr heart tο pump harder tο force blood through thÐµ narrow Ñ€°rt οf Ñƒουr aorta. Symptoms οf coarctation οf aorta include pale skin, shortness οf breath °nd heavy sweating.
ThÐµrÐµ °rÐµ many more types οf non-cyanotic such °Ñ• pulmonic stenosis, patent ductus arteriorus, °nd atrioventricular cana. ThÐµÑ•Ðµ problems m°Ñƒ occur alone οr together. MοÑ•t congenital heart diseases occur °Ñ• °n isolated defect -Ñ• nοt associated w-th οthÐµr diseases.