Total anomalous pulmonary venous connection physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The physical findings depend on the degree of obstruction and the degree of left-to-right shunting. | The physical findings depend on the degree of obstruction and the degree of [[Left-to-right shunt|left-to-right shunting]]. [[Physical examination]] of [[patients]] may be remarkable for a decreased [[pulse]], [[hypotension]], [[tachypnea]], peripheral [[edema]], [[S3 gallop]], [[diastolic murmur]] due to tricuspid regurgitation, [[hepatomegaly]], and [[cyanosis]]. | ||
==Physical Examination== | ==Physical Examination== | ||
The physical examination in patients with total anomalous pulmonary venous connection depends on the following factors:<ref name="Driscoll2016">{{cite journal|last1=Driscoll|first1=David J.|title=Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return|year=2016|pages=369–371|doi=10.1007/978-3-7091-1883-2_28}}</ref> | The [[physical examination]] in [[patients]] with total anomalous pulmonary venous connection depends on the following factors:<ref name="Driscoll2016">{{cite journal|last1=Driscoll|first1=David J.|title=Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return|year=2016|pages=369–371|doi=10.1007/978-3-7091-1883-2_28}}</ref><ref name="Pollack2019">{{cite journal|last1=Pollack|first1=Charles V.|year=2019|doi=10.1007/978-3-319-63895-9}}</ref> | ||
* Type of anatomic connection present between systemic and pulmonary venous circulation | * Type of anatomic connection present between systemic and pulmonary venous circulation | ||
* Degree of obstruction | * Degree of obstruction | ||
* Type of obstruction (obstructed, unobstructed) | * Type of obstruction (obstructed, unobstructed) | ||
* Amount of right to left shunting | * Amount of [[right to left shunting]] | ||
===Vitals=== | ===Vitals=== | ||
====Pulse==== | ====Pulse==== | ||
* Decreased pulses (low systemic blood flow) | * Decreased [[pulses]] (low systemic blood flow) | ||
====Blood Pressure==== | ====Blood Pressure==== | ||
* [[Hypotension]] (low systemic blood flow) | * [[Hypotension]] (low systemic blood flow) | ||
====Respiratory Rate==== | ====Respiratory Rate==== | ||
* [[Tachypnea]] (right sided volume overload) | * [[Tachypnea]] (right sided volume overload) | ||
* Peripheral [[edema]] ([[right heart failure|right sided heart failure]]) | * Peripheral [[edema]] ([[right heart failure|right sided heart failure]]) | ||
===Heart=== | ===Heart=== | ||
* [[Cardiovascular]] examination of [[patients]] with total anomalous pulmonary venous connection may be remarkable for: | |||
====Inspection==== | ====Inspection==== | ||
* Precodial asymmetry indicating right [[ventricular hypertrophy]] may be present | * Precodial asymmetry indicating right [[ventricular hypertrophy]] may be present. | ||
====Palpation==== | ====Palpation==== | ||
* Right ventricular [[heave]] or lift may be present | *[[Right ventricular]] [[heave]] or lift may be present. | ||
====Auscultation==== | ====Auscultation==== | ||
=====Heart Sounds===== | =====Heart Sounds===== | ||
* Prominent, fixed [[split second heart sound]] (S2) is present | * Prominent, fixed [[split second heart sound]] (S2) is present. | ||
* [[S3 gallop]] may be present | * [[S3 gallop]] may be present. | ||
{{#ev:youtube|f2WYFIT_09Q}} | {{#ev:youtube|f2WYFIT_09Q}} | ||
=====Murmurs===== | =====Murmurs===== | ||
* [[Systolic ejection murmur]] due to increased stroke volume across the pulmonary valve best heard at left upper sternal border may be present. Ejection murmurs are more prominent in unobstructed [[TAPVC]]. | * [[Systolic ejection murmur]] due to increased [[stroke volume]] across the [[pulmonary valve]] best heard at the [[Left sternal border|left upper sternal border]] may be present. [[Ejection murmurs]] are more prominent in unobstructed [[TAPVC]]. | ||
* [[Diastolic murmur]] due to tricuspid regurgitation may be present. | * [[Diastolic murmur]] due to [[tricuspid regurgitation]] may be present. | ||
===Abdomen=== | ===Abdomen=== | ||
* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
===Extremities=== | ===Extremities=== | ||
* [[Cyanosis]] (right to left shunt) | * [[Cyanosis]] ([[right to left shunt]]) | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Cardiovascular system]] | [[Category:Cardiovascular system]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
| Line 53: | Line 47: | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 23:55, 14 April 2020
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Total anomalous pulmonary venous connection Microchapters |
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Differentiating Total anomalous pulmonary venous connection from other Diseases |
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Diagnosis |
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Treatment |
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Total anomalous pulmonary venous connection physical examination On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS [4]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]
Overview
The physical findings depend on the degree of obstruction and the degree of left-to-right shunting. Physical examination of patients may be remarkable for a decreased pulse, hypotension, tachypnea, peripheral edema, S3 gallop, diastolic murmur due to tricuspid regurgitation, hepatomegaly, and cyanosis.
Physical Examination
The physical examination in patients with total anomalous pulmonary venous connection depends on the following factors:[1][2]
- Type of anatomic connection present between systemic and pulmonary venous circulation
- Degree of obstruction
- Type of obstruction (obstructed, unobstructed)
- Amount of right to left shunting
Vitals
Pulse
- Decreased pulses (low systemic blood flow)
Blood Pressure
- Hypotension (low systemic blood flow)
Respiratory Rate
- Tachypnea (right sided volume overload)
- Peripheral edema (right sided heart failure)
Heart
- Cardiovascular examination of patients with total anomalous pulmonary venous connection may be remarkable for:
Inspection
- Precodial asymmetry indicating right ventricular hypertrophy may be present.
Palpation
- Right ventricular heave or lift may be present.
Auscultation
Heart Sounds
- Prominent, fixed split second heart sound (S2) is present.
- S3 gallop may be present.
{{#ev:youtube|f2WYFIT_09Q}}
Murmurs
- Systolic ejection murmur due to increased stroke volume across the pulmonary valve best heard at the left upper sternal border may be present. Ejection murmurs are more prominent in unobstructed TAPVC.
- Diastolic murmur due to tricuspid regurgitation may be present.
Abdomen
Extremities
References
- ↑ Driscoll, David J. (2016). "Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return": 369–371. doi:10.1007/978-3-7091-1883-2_28.
- ↑ Pollack, Charles V. (2019). doi:10.1007/978-3-319-63895-9. Missing or empty
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