Congenital Heart Defects

Wall Opening or Obstruction

Acyanotic heart disease is the most common birth defect in the United States.  It is an expansive term for any congenital heart defect in which blood returns to the right side of the heart passes through the lungs and pulmonary vasculature in the usual fashion. The most common forms of them are the ones that have a defect in one of the walls separating the chambers of the heart, or obstruction to one valve or artery.  [1]  Severe cases of acyanotic varieties may include infants failing to flourish and may have breathing difficulties.  [2]

No Hindrance of Oxygen or Blood Flowing Out

Acyanotic heart defects usually do not normally create hindrance with the amount of oxygen or blood that reaches the body's tissues. Thus, it doesn’t cause babies to have bluish skin, lips, and nail beds from lack of oxygen flowing - known as cyanosis.  If it does develop in newborns, it usually happens as a result of needing more oxygen during increased activity such as crying and feeding.  [3]   

Types of Acyanotic Heart Disease

Aortic Stenosis (AS)
Atrial Septal Defect (ASD)
Atrioventricular Septal Defect (AVSD)
Coarctation of the Aorta (CoA)
Hypoplastic Left Heart Syndrome (HLHS)
Patent Ductus Arteriosus (PDA)
Pulmonary Stenosis (PS)
Tricuspid Atresia (TA)
Truncus Arteriosus (TA)
Total Anomalous Pulmonary Venous Return (TAPVR)
Transposition of the Great Vessels (TGA)
Tetralogy of Fallot (ToF)
Ventricular Septal Defect (VSD)

Slideshow of Septal Defects

There is a slideshow available for people to view and learn more about acyanotic heart defects.  It has some information on  Atrial Septal Defect’s incidence and pathophysiology, types of lesions that come with it, altered hemodynamics, manifestations, ways to diagnose it, therapeutic management, medical management, and surgical management.  It also has information on Ventricular Septal Defect’s manifestations, clinical manifestations, complications, ways to diagnose it, therapeutic management, medical management, and surgical management.  [4]

The slideshow also lists the nursing diagnosis and care of acyanotic children with left-to-right shunting.  Medical professionals need to learn how to deal with impaired gas exchange, be aware of risk for impaired growth and development, altered nutrition involving less than body requirements, and risk for infections.  [4]

The slideshow can be viewed at 

Problems with the Respiratory System

Children with acyanotic congenital heart disease usually develop respiratory difficulties, which can be effected by the compression of the tracheobronchial tree by hypertensive dilated pulmonary arteries.  Possible locations of predilection for compression include the left main bronchus, the upper lobe bronchus, the left side of the distal trachea, and the junction of the right bronchus intermedius and right middle lobe bronchus.  Cardiac disorders including ventricular septal defect, patent ductus arteriosus, interruption of the aortic arch, and Tetralogy of Fallot leads to tendencies of tracheobronchial compression.  A procedure called pulmonary arteriopexy - dilating pulmonary arteries - may be able to relieve the tracheobronchial compression.  [5 - 6]