Congenital cyanotic heart disease: Difference between revisions

	Congenital cyanotic heart disease Microchapters
Overview
Classification • Tetralogy of Fallot • Total anomalous pulmonary venous connection • Transposition of the great arteries • Truncus arteriosus • Ebstein's anomaly
Differential Diagnosis

VisualWikitext

Latest revision as of 19:15, 14 April 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D. Eiman Ghaffarpasand, M.D. [2]

Overview

Congenital cyanotic heart disease is a group of heart defects that will causes neonatal cyanosis. The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries. Such defects include persistent truncus arteriosus, total anomalous pulmonary venous connection, tetralogy of Fallot, transposition of the great vessels, and Ebstein's anomaly.

Classification

Congenital cyanotic heart disease may be classified according to anatomical defect into 5 subgroups:

Tetralogy of fallot
- It is understood that tetralogy of fallot is the result of improper positioning of the outlet septum.
- In the normal heart, the outlet septum is an indistinguishable component of the crista supraventricularis that communicates with the septomarginal trabeculae to divide the right and left ventricular cavities.
- In Tetralogy of Fallot, proper ventricular septation is perturbed by anterocephalad displacement of the outlet septum relative to the septomarginal trabecula.
- The direct consequence of this misalignment is an overriding aortic orifice and a ventricular septal defect, resulting in an intracardiac right to left shunt of blood.
- In addition, anterocephalad displacement of the outlet septum indirectly predisposes the pulmonary trunk to stenosis in the setting of septoparietal trabecular hypertrophy.
- Together, the displacement of the outlet septum coupled with the hypertrophic arrangement of the septoparietal trabeculae account for the three anatomical cardinal defects in Tetralogy of Fallot - aortic dextroposition, interventricular communication (VSD), and pulmonary stenosis.
- The fourth defect - right ventricular hypertrophy - is a hemodynamic consequence of these three morphologic changes, as the right ventricle physiologically adapts to the increased resistance of a stenotic pulmonary trunk.
Total anomalous pulmonary venous connection
- n this condition,the right side of heart is receiving blood both from pulmonary and systemic circulation.
- There is a mixing of oxygenated pulmonary venous blood with deoxygenated blood from systemic circulation.
- The mixing of blood could occur at three levels i.e. supracardiac, infracardiac and cardiac.
- In the former two the mixing occurs outside the heart and in latter inside the heart (right atrium).
Transposition of the great arteries
- In the TGA the aorta arises from the morphologic right ventricle via a subaortic infundibulum and the pulmonary artery arises from the morphologic left ventricle, without a subpulmonary infundibulum.
- These ventriculoarterial connection is known as ventriculoarterial discordance.
- As a consequence, there is a a fibrous continuity between the mitral and pulmonary valve, but no continuity between the tricuspid and aortic valve.
- The abnormal origin of the great arteries results in an altered spiral relationship.
- Therefore, the aorta and pulmonary artery run parallel to each other
- In normal heart thus the circulation is in series.
- However, in transposition of the great vessels circulation is in parallel
Truncus arteriosus
- In truncus arteriosus, the pulmonary arteries are connected to the aorta.
- A decrease in PVR at birth causes a left to right shunt with evidence of congestive heart failure.
- These patients have a very high incidence of pulmonary hypertension and vascular disease.
Ebstein's anomaly
- Pathophysiology mainly involves the right ventricle, right atrium and tricuspid valve:
  - Failure of TV(tricuspid valve) leaflet delamination
  - Apical descent of the functional tricuspid orifice
  - Right ventricular dilation and “atrialization”
  - Anterior leaflet abnormal fenestrations and tethering
  - Right atrioventricular junction dilation

Differential diagnosis

Congenital cyanotic heart disease should be differentiated from other conditions that causes cyanosis:

					Symptoms			Physical examination			Lab Findings				Imaging
Diseases			Cyanosis		Clinical manifestations						Para-clinical findings							Gold standard	Additional findings
					Symptoms			Physical examination			Para-clinical findings
			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other
Pulmonary diseases	Airway disorder	Severe croup^[1]	+	-	+	+/-	-	-	-	Stridor	Lymphocytosis	Normal	Normal	-	Steeple sign	Normal	Distended hypopharynx during inspiration	Clinical findings	Intercostal and subcostal retraction, Barking cough
		Epiglottitis^[2]	+	-	+	+	-	-	-	Stridor	Leukocytosis with neutrophilia	Normal	Normal	-	Thumb sign	Normal	-	Laryngoscopy	Muffled voice, Drooling
		Foreign body aspiration^[3]	+	-	+	-	+/-	-	-	Decreased breath sounds, Wheezing	Normal	Normal	Normal	-	Hyperinflation, Atelectasis, Objects	Foreign body entrapment with edema or granulation tissue	-	Bronchoscopy	Mediastinitis
		Bacterial tracheitis^[4]	+	-	+	+	+	-	-	Inspiratory stridor	Leukocytosis	Normal	Normal	Blood culture, Gram stain	Irregular tracheal margin	Normal	Steeple sign (confusing)	Laryngotracheobronchoscopy	Brassy cough, Hoarseness
		Sleep apnea^[5]	-	+	+	-	-	-	-	Normal	Polycythemia	↓O2, ↑CO2	Normal	-	Normal	Normal	Polysomnography	Polysomnography	Nightmares, Snoring
		Chronic bronchitis^[6]	-	+	+	+/-	+/-	+	-	Rales, crackles, Wheeze	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Hypokalemia, Hypernatremia	Gram stain of sputum	Elongated heart, Flattened diaphragms, Prominent hilar vasculature	Bronchial wall thickening with increased bronchovascular markings	-	HRCT	Productive cough, Chest tightness
		Atelectasis^[7]	-	+	+	-	+	-	-	Localized diminished breath sounds, Wheeze	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Normal	-	Localized increased opacity, Deviation toward the atelectasis	Local crowding of pulmonary vessels and bronchi	MRI for distinguishing obstructive from non-obstructive	HRCT	Cough, Shallow breathing
	Parenchymal disorder	Alveolitis^[8]	+/-	+	+	+	+	+/-	-	Wheeze, Crackles	Leukocytosis, Eosinophilia	↓O2, ↑CO2	Normal	↑ESR, ↑CRP	Scattered opacities, Fine reticulation	Homogeneous ground-glass opacity	-	HRCT PLUS Clinical findings	Malaise, Chills, Headache
		Pneumonia^[9]	-	+	+	+	+	+/-	-	Rales, Crackles, Wheeze, Pleural friction rub	Leukocytosis with neutrophilia	Normal	Hyponatremia	-	Entire lobe consolidated, Air bronchograms	Focal ground-glass opacity	-	HRCT	Tachycardia, Bradycardia (Legionella)
		Asthma (Late)^[10]	-	+	+	-	+/-	+/-	-	End expiratory wheeze	Eosinophilia	↓O2, ↑CO2	Normal	↑ IgE	Atelectasis	Allergic bronchopulmonary aspergillosis, Bronchiectasis	-	Spirometry before and after bronchodilator	Triad of asthma, nasal polyps, and rash is indicative of aspirin sensitivity.
		Cystic fibrosis^[11]	+	-		+/-	+/-	+	-	Wheeze, Crackles	Normal	↓O2, ↑CO2	Increased sweat chloride	Sweat chloride test	Hyperinflation, Nodules	Peribronchial thickening, Bronchiectasis	-	Sweat chloride test	Absent vas deferens
		COPD (Severe emphysema)^[12]	+	-	+	+/-	+	+/-	+/-	Reduced breath sounds, Wheeze, Inspiratory crackles	Polycythemia	↓O2, ↑CO2	Normal	Alpha 1-antitrypsin test	Elongated heart, Flattened diaphragms, Prominent hilar vasculature	Bullae	-	HRCT	Pulmonary hypertension, Right heart failure
		Tuberculosis^[13]	-	+	+	+	+	+/-	-	Reduced breath sounds, Wheeze, Inspiratory crackles	Leukocytosis, ↑Lymphocyte	↓O2, ↑CO2	Hyponatremia, Hyperkalemia, Hypochloremia	PPD, interferon-gamma release assay (IGRA)	Dense, homogeneous parenchymal consolidation	Nodules with low-density centers and rim enhancement	Fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT)	Sputum culture, QuantiFERON-TB Gold (QFT)	Loss of appetite, Night sweats
		Pulmonary fibrosis^[14]	-	+	+	-	+	+	-	Inspiratory crackles	Anemia	↓O2, ↑CO2	Normal	Matrix metalloproteinases (MMPs)	Honeycombing	Traction bronchiectasis, Interlobular septal thickening	HRCT	HRCT	Fatigue, Weight loss
		Pneumoconiosis^[15]	-	+	+	-	+/-	+/-	-	End expiratory wheeze	Leukocytosis, Anemia	↓O2, ↑CO2, Respiratory acidosis	Hyper/Hypocalcemia, Hypermagnesemia	-	Small to large round nodular opacities	Diffuse distribution of small nodules	MRI and PET-CT scan	CT/HRCT scan	Tightness in the chest
		Lung cancer^[16]	-	+	+	-	+/-	+	-	Absence of breath sounds, Stridor, Wheezing	Leukocytosis, Anemia	↓O2, ↑CO2	Hyponatremia	↑CRP, ↑ESR	Pulmonary nodule or mass, Mediastinal widening Hilar lymphadenopathy	Massive lymphadenopathy, Direct mediastinal invasion	MRI, PET-CT scan, Bronchoscopy	Low dose computed tomography scan (LDCT)	Weight loss, Loss of appetite
		Acute respiratory distress syndrome^[17]	-	+	+	+/-	+	-	-	Inspiratory crackles	Leukopenia/Leukocytosis	↓O2, ↓CO2, Respiratory alkalosis	Hyponatremia, Hyperkalemia	↑BNP, ↑Von Willebrand factor (VWF)	Bilateral pulmonary infiltrates (patchy to diffuse)	Emphysema, Pneumothorax and pneumomediastinum, Mediastinal lymphadenopathy	Invasive Hemodynamic Monitoring (PCWP), Bronchoscopy	Chest CT scan	Tachypnea, Muscle weakness
	Pulmonary vascular disorders	Massive pulmonary embolism^[18]	+	-	+	+/-	+	-	+/-	Reduced breath sounds, Crackles, Loud P2	Leukocytosis	↓O2, ↑CO2, Respiratory acidosis	Normal	D-dimer, BNP	Fleischner sign, Hampton hump, Westermark sign, Pleural effusion	Filling defects in the pulmonary vasculature	Spiral CT pulmonary angiogram	Spiral CT pulmonary angiogram	Tachycardia, Shock, Pulmonary hypertension
		Pulmonary arterio-venous malformation^[19]^[20]^[21]	-	+	+	-	+	+	-	Pulmonary bruit	Normal	↓O2, ↑CO2, Respiratory acidosis	Normal	-	One or more rounded or multilobular opacities	Connecting vessel in hilum	Magnetic resonance angiography, Echocardiography	Contrast enhanced magnetic resonance angiography	Cerebral arteriovenous malformation
		Pulmonary hypertension^[22]	-	+	+	-	+/-	+/-	-	Tricuspid regurgitation murmur, Pulmonic insufficiency murmur	Mild anemia	↓O2, ↑CO2	Hypernatremia	↑BNP, ↑ANP	Right deviated cardiac apex, Prominent pulmonary artery	Ill-defined nodules, Interlobular septal thickening	CT pulmonary angiography (CTPA), MRA	Cardiac catheterization (PCWP)	Fatigue, Inability to exercise
Chest wall disorders		Flail chest^[23]	+	-	+	-	+	-	-	Normal	Normal	↓O2, ↑CO2	Normal	-	≥3 adjacent ribs with segmental fractures, >5 adjacent rib fractures	Normal	-	CXR	Bruises over chest
Chest wall disorders		Pneumothorax^[24]	+	-	+	-	+	-	-	Diminished breath sounds	Normal	↓O2, ↑CO2	Normal	-	No lung marking on one side, Collapsed lung	Loculated air in thoracic cavity	M-mode ultrasonography	Chest CT scan	Tachypnea
Disease			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other	Gold standard	Additional findings
Cardiac diseases	Congenital disorders	Atrioventricular canal defect^[25]	+/-	+	+	-	+/-	+/-	-	Wheezing,Holosystolic or systolic ejection murmur	Normal	Normal	Normal	Pulse oximetry	Cardiomegaly, Increased pulmonary vascular markings	Normal	Echocardiography, MRI	Echocardiography	Tachypnea, Lack of appetite, Pale skin color, Excessive sweating
		Ebstein anomaly^[26]	-	+	+/-	-	+/-	-	-	Loud S1	Normal	Normal	Normal	Pulse oximetry	Cardiomegaly, "Box shape" heart	Apical displacement of the septal and posterior leaflets of the tricuspid valve	"Atrialisation" of the right ventricle in MRI, Tricuspid regurgitation in echocardiography	Echocardiography	Fatigue, Palpitations
		Tetralogy of Fallot^[27]	-	+	+/-	-	+/-	-	-	Harsh systolic murmur	Normal	Normal	Normal	Pulse oximetry	"Boot-shaped" heart with an upturned cardiac apex	Aortopulmonary collateral vessels	Peripheral pulmonary stenosis and atresia in echocardiography	Echocardiography	Fainting, Palpitation
		Pulmonic stenosis^[28]	-	+	+	-	+	+/-	-	Crescendo-decrescendo ejection murmur	Schistocyte	↓O2	Normal	Pulse oximetry	Right ventricular hypertrophy, Dilated main pulmonary artery	Stenotic segment, Post stenotic dilatation	Severity of the stenosis by velocity encoded phase contrast (VEC) cine sequences	Echocardiography	Fainting, Palpitation
		Total anomalous pulmonary venous connection^[29]	-	+	+	-	+/-	+/-	-	Systolic murmur over the pulmonary area	Normal	↓O2	Normal	Pulse oximetry	Snowman sign	Anomalous venous return	Blind ended left atrium with no connecting veins in echocardiography	Echocardiography	Pounding heart, Weak pulse, Extreme sleepiness
		Transposition of the great vessels^[30]	-	+	+	-	+/-	+/-	-	Diastolic and Systolic murmur	Normal	↓O2	Normal	Pulse oximetry	Cardiomegaly with narrow superior mediastinum (egg on a string sign)	Abnormal great vessel anatomy	Flow dynamics on Steady-state free precession (SSFP) MRI	Echocardiography	Lack of appetite, Poor weight gain
		Truncus arteriosus^[31]	-	+	+/-	-	+/-	+/-	-	Holosystolic or ejection type murmur	Normal	↓O2	Normal	Pulse oximetry	Moderate cardiomegaly, pulmonary plethora, Widened mediastinum	Single cardiac trunk	Anomalous anatomy in MRI	Echocardiography	Fatigue, Sweating, Pale or cool skin
		Patent ductus arteriosus^[32]	-	+	+/-	-	+/-	+/-	-	Continuous machinery murmur	Normal	↓O2, ↑CO2	Normal	Pulse oximetry	Cardiomegaly, Aortopulmonary window obsecuration	Tortuous morphology of ductus (Krichenko classification)	Spiral CT pulmonary angiogram	Echocardiography	Failure to thrive, Respiratory distress
	Acquired disorders	Heart failure^[33]	+	-	+	+/-	+	-	+	Coarse crackles, S3	Anemia	↓O2, ↑CO2	Hyponatremia, Hypokalemia, Hypomagnesemia	Elevated BNP	Pleural effusion, Cardiomegaly Kerley B lines	Normal	Radioisotope scan	Echocardiography	Generalized edema, Hepatomegaly
		Valvular heart disease^[34]	+	-	+	-	-	-	+	Murmurs	Schistocyte	Normal	Normal	Hyperthyroidism	Valve calcification	Normal	Valvular dysfunction in echocardiography	Echocardiography	Syncope, Palpitation
		Myocardial infarction^[35]	-	+	+	+/-	+	-	-	S3 and S4	Normal	Normal	Hyponatremia, Hypokalemia	Elevated troponin I and CKMB	Rolling out other causes	Coronary luminal narrowing in CT perfusion scan	Wall motion abnormality in echocardiography	Cardiac troponin I	Dizziness, Fatigue, Lightheadedness, Cold sweat
		Cardiogenic shock^[36]	+/-	+	+	-	-	-	+	Muffled heart sound	Anemia	↓O2, ↑CO2	Hyperkalemia	↓PaO2 in pulse oximetry	Normal	Normal	Echocardiography	Clinical findings	Tachypnea, Palpitation, Hypotension, Weak pulse
		Cardiomyopathy^[37]	-	+	+	-	+	+	+	S3 and S4	Lymphocytosis	↓O2, ↑CO2	Normal	↓PaO2 in pulse oximetry	Enlarged left ventricle and atria, Pulmonary edema	Normal	MRI	Endomyocardial biopsy	Arrhythmia, Bloating
		Heart tumors^[38]	-	+	+	-	+/-	+/-	+/-	Early diastolic tumor plop	Normal	Normal	Normal	Mild ↓PaO2 in pulse oximetry	Calcification in lateral view	Intracardiac mass	Echocardiography	Histologic diagnosis (biopsy)	Syncope, Weight loss
		Mitral Stenosis^[39]	-	+	+	-	+/-	+/-	+/-	Diastolic murmur	Normal	Normal	Normal	Mild ↓PaO2 in pulse oximetry	Left atrial enlargement, Mitral annular calcification	Secondary pulmonary hemosiderosis	Velocity-encoded cine-magnetic resonance imaging (VEC-MRI)	Echocardiography	Dizziness, Hemoptysis
Vascular disease	Arterial disorders	Acrocyanosis^[40]	+	-	+/-	-	-	+	-	Normal	Anemia, Leukocytosis	↓O2, ↑CO2	Hypercalcemia	↓PaO2 in pulse oximetry	Normal	Normal	-	Clinical findings	Brittle nails, Telangiectasia
		Arterial embolism^[41]	+	-	+	-	+	+/-	-	Normal	Normal	Normal	Hyperkalemia	↓PaO2 in pulse oximetry	Normal	Normal	Transesophageal echocardiography (TEE)	Clinical findings	Headache, Decreased sensation
		Raynaud's Phenomenon^[42]	+	-	-	-	-	+	-	Normal	Polycythemia	↓O2	Normal	Mild ↓PaO2 in pulse oximetry	Normal	Normal	-	Clinical findings	Sensitivity to cold, Decreased sensation
	Venous disorders	Superior vena cava obstruction^[43]	+	-	+/-	-	+/-	+/-	+	Normal	Polycythemia	↓O2	Normal	↓PaO2 in pulse oximetry	Superior mediastinal widening, Right hilar prominence	Thrombosis, Mediastinal mass or lymphadenopathy, Associated lung mass	-	Chest CT scan	Headache, Facial swelling
	Venous disorders	Venous stasis^[44]	+	-	-	-	-	+/-	+	Normal	Polycythemia	↓O2	Hypercalcemia	Normal	Normal	Normal	Color-flow duplex ultrasound	Color-flow duplex ultrasound	Leg swelling, Pain during walking, Leg ulcers
Disease			Peripheral	Central	Dyspnea	Fever	Chest pain	Clubbing	Peripheral edema	Auscultation	CBC	ABG	Electrolytes	Other	X-ray	CT scan	Other	Gold standard	Additional findings
Hematologic diseases		Methemoglobinemia^[45]	-	+	+	+/-	+	-	-	Wheezing	Anemia, Methemoglobinemia	Normal PaO2, ↑SaO2, "Saturation gap"	Normal	↓SaO2 in pulse oximetry	Normal	Normal	Echocardiography for ruling out other causes	Co-oximetry, ABG paired with pulse oximetry. Serum methemoglobin levels	Headache, Altered mental status, Delirium, Seizure, Coma
Hematologic diseases		Polycythemia^[46]	+	+	+	+/-	+/-	+	-	Normal	↑RBC, ↑WBC, ↑HGB, ↑Plt	↓O2	Hyperkalemia	↑Leukocyte alkaline phosphatase, ↑Ferritin, ↑Erythropoietin	AVM, COPD, pulmonary hypertension	Normal	Abdominal ultrasound or renal vascular studies for ruling out renal artery stenosis	RBC mass (RCM) and plasma volume measurement	Itchiness, Headache. Dizziness. Blurred vision
Neurological disease		Breath-holding spells^[47]	-	+	+	-	+/-	-	-	Wheezing	Hypochromic microcytic anemia	↓O2	Hypocalcemia, Hypokalemia	Iron deficiency	Ruling out foreign body aspiration	Normal	EEG monitoring	Clinical findings	Fainting, Twitching muscles, Seizure
		Seizure^[48]	-	+	+	+/-	-	-	-	Normal	Normal	↓O2, ↑CO2	Hyponatremia, Hypo/Hypercalcemia	↑CPK, ↑LDH,	Normal	Normal	EEG	EEG	Fainting, Tonic-clonic movements
		Coma^[49]	-	+	-	-	-	-	+/-	Wheezing	Normal	↓O2, ↑CO2	Normal	-	Underlying disease	Underlying disease	-	Glasgow Coma Scale (GCS)	Depressed brainstem reflexes, Agonal breathing
		Head trauma^[50]	-	+	+	-	-	-	-	Normal	Normal	↓O2, ↑CO2	Normal	-	Skull fracture	Intracranial hemorrhage	MRI	CT scan	Nausea, Hypertension, Bradycardia,Tachypnea
Miscellaneous		High altitude exposure^[51]	+/-	+	+	-	+/-	+	-	Wheezing	Polycythemia	↓O2, ↓CO2, Respiratory alkalosis	Hyperphosphatemia, Hypercalcemia, Hyponatremia, Hypokalemia, Hypomagnesemia	Decreased bicarbonate	Central interstitial edema	Pulmonary consolidation	-	Hypoxic challenge test	Dizziness, Coma, Death
		Septic shock^[52]	+	-	+	+	+/-	-	-	Rales, crackles, Wheeze, Pleural friction rub	Leukocytosis with neutrophilia	↓O2, ↑CO2, Metabolic acidosis	Hyperkalemia	↑ESR, ↑CRP	Consolidation	Pulmonary infiltration	Echocardiography	Blood culture	Chills, Hypothermia, Loss of consciousness
		Smoke inhalation^[53]	+/-	+	+	-	+	-	-	Wheezing	Anemia, Carboxyhemoglobin	↓O2, ↑CO2, Respiratory acidosis	Normal	CO-oximetry	Diffuse opacities	Pulmonary infiltration	Pulmonary function testing	Bronchoscopy	Cough, Hoarseness, Hemoptysis, Headache, Fainting
		Cold exposure^[54]	+	-	+/-	-	-	-	-	Normal	Leukopenia, ↑RBC	↓O2, ↑CO2, Metabolic acidosis	Hypokalemia, Hypocalcemia	Hyperglycemia, ↑CK	Normal	Normal	-	Clinical findings	Confusion, Tachycardia/Bradycardia, Coma

References

↑ Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
↑ Abdallah C (2012). "Acute epiglottitis: Trends, diagnosis and management". Saudi J Anaesth. 6 (3): 279–81. doi:10.4103/1658-354X.101222. PMC 3498669. PMID 23162404.
↑ Qureshi A, Behzadi A (2008). "Foreign-body aspiration in an adult". Can J Surg. 51 (3): E69–70. PMC 2496600. PMID 18682760.
↑ Liston SL, Gehrz RC, Siegel LG, Tilelli J (August 1983). "Bacterial tracheitis". Am. J. Dis. Child. 137 (8): 764–7. PMID 6869336.
↑ Spicuzza L, Caruso D, Di Maria G (2015). "Obstructive sleep apnoea syndrome and its management". Ther Adv Chronic Dis. 6 (5): 273–85. doi:10.1177/2040622315590318. PMC 4549693. PMID 26336596.
↑ Kim V, Criner GJ (2013). "Chronic bronchitis and chronic obstructive pulmonary disease". Am J Respir Crit Care Med. 187 (3): 228–37. doi:10.1164/rccm.201210-1843CI. PMC 4951627. PMID 23204254.
↑ Peroni DG, Boner AL (September 2000). "Atelectasis: mechanisms, diagnosis and management". Paediatr Respir Rev. 1 (3): 274–8. doi:10.1053/prrv.2000.0059. PMID 12531090.
↑ Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). "Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT". Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.
↑ Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
↑ Litonjua AA (June 2009). "Childhood asthma may be a consequence of vitamin D deficiency". Curr Opin Allergy Clin Immunol. 9 (3): 202–7. doi:10.1097/ACI.0b013e32832b36cd. PMID 19365260.
↑ "Cystic fibrosis - Genetics Home Reference".
↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
↑ Olalekan, Adebimpe Wasiu; Oluwaseun, Faremi Ayodeji; Oladele, Hassan Abdul-Wasiu; Akeem, Adeyemi Damilare (2015). "Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria". Alexandria Journal of Medicine. 51 (3): 255–260. doi:10.1016/j.ajme.2014.10.003. ISSN 2090-5068.
↑ Shaw J, Marshall T, Morris H, Hayton C, Chaudhuri N (2017). "Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age". J Thorac Dis. 9 (11): 4700–4707. doi:10.21037/jtd.2017.10.111. PMC 5721024. PMID 29268540.
↑ Yen CM, Lin CL, Lin MC, Chen HY, Lu NH, Kao CH (2016). "Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study". Medicine (Baltimore). 95 (25): e3972. doi:10.1097/MD.0000000000003972. PMC 4998335. PMID 27336897.
↑ Hartwig MG, D'Amico TA (June 2010). "Thoracoscopic lobectomy: the gold standard for early-stage lung cancer?". Ann. Thorac. Surg. 89 (6): S2098–101. doi:10.1016/j.athoracsur.2010.02.102. PMID 20493989.
↑ Ochiai R (2015). "Mechanical ventilation of acute respiratory distress syndrome". J Intensive Care. 3 (1): 25. doi:10.1186/s40560-015-0091-6. PMC 4456061. PMID 26045965.
↑ Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.
↑ Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.
↑ Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G (2009). "Massive spontaneous hemothorax during the immediate postpartum period". Tex Heart Inst J. 36 (3): 247–9. PMC 2696501. PMID 19568398.
↑ Chanatry BJ (1992). "Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy". Anesth. Analg. 74 (4): 613–5. PMID 1554132.
↑ Hoeper MM, Ghofrani HA, Grünig E, Klose H, Olschewski H, Rosenkranz S (2017). "Pulmonary Hypertension". Dtsch Arztebl Int. 114 (5): 73–84. doi:10.3238/arztebl.2017.0073. PMC 5331483. PMID 28241922.
↑ Pettiford BL, Luketich JD, Landreneau RJ (February 2007). "The management of flail chest". Thorac Surg Clin. 17 (1): 25–33. doi:10.1016/j.thorsurg.2007.02.005. PMID 17650694.
↑ Luh SP (2010). "Review: Diagnosis and treatment of primary spontaneous pneumothorax". J Zhejiang Univ Sci B. 11 (10): 735–44. doi:10.1631/jzus.B1000131. PMC 2950234. PMID 20872980.
↑ Macris MP, Ott DA, Cooley DA (1992). "Complete atrioventricular canal defect: surgical considerations". Tex Heart Inst J. 19 (3): 239–43. PMC 326195. PMID 15227445.
↑ Safi LM, Liberthson RR, Bhatt A (September 2016). "Current Management of Ebstein's Anomaly in the Adult". Curr Treat Options Cardiovasc Med. 18 (9): 56. doi:10.1007/s11936-016-0478-2. PMID 27439413.
↑ Bailliard F, Anderson RH (2009). "Tetralogy of Fallot". Orphanet J Rare Dis. 4: 2. doi:10.1186/1750-1172-4-2. PMC 2651859. PMID 19144126.
↑ Yoo BW, Park HK (2013). "Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair". Korean J Pediatr. 56 (6): 235–41. doi:10.3345/kjp.2013.56.6.235. PMC 3693041. PMID 23807889.
↑ Stein P (March 2007). "Total anomalous pulmonary venous connection". AORN J. 85 (3): 509–20, quiz 521–4. doi:10.1016/S0001-2092(07)60123-9. PMID 17352891.
↑ Martins P, Castela E (2008). "Transposition of the great arteries". Orphanet J Rare Dis. 3: 27. doi:10.1186/1750-1172-3-27. PMC 2577629. PMID 18851735.
↑ Van Praagh R (1987). "Truncus arteriosus: what is it really and how should it be classified?". Eur J Cardiothorac Surg. 1 (2): 65–70. PMID 2856609.
↑ "Patent Ductus Arteriosus - National Library of Medicine - PubMed Health".
↑ Inamdar AA, Inamdar AC (2016). "Heart Failure: Diagnosis, Management and Utilization". J Clin Med. 5 (7). doi:10.3390/jcm5070062. PMC 4961993. PMID 27367736.
↑ Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.
↑ "Myocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health".
↑ Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA; et al. (2012). "Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline". Dtsch Arztebl Int. 109 (19): 343–51. doi:10.3238/arztebl.2012.0343. PMC 3364528. PMID 22675405.
↑ Marian AJ, Braunwald E (September 2017). "Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy". Circ. Res. 121 (7): 749–770. doi:10.1161/CIRCRESAHA.117.311059. PMID 28912181.
↑ Hoffmeier A, Sindermann JR, Scheld HH, Martens S (2014). "Cardiac tumors--diagnosis and surgical treatment". Dtsch Arztebl Int. 111 (12): 205–11. doi:10.3238/arztebl.2014.0205. PMC 3983698. PMID 24717305.
↑ Kannan M, Vijayanand G (2010). "Mitral stenosis and pregnancy: Current concepts in anaesthetic practice". Indian J Anaesth. 54 (5): 439–44. doi:10.4103/0019-5049.71043. PMC 2991654. PMID 21189882.
↑ Das S, Maiti A (2013). "Acrocyanosis: an overview". Indian J Dermatol. 58 (6): 417–20. doi:10.4103/0019-5154.119946. PMC 3827510. PMID 24249890.
↑ Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ (2013). "Arterial embolism". Int J Crit Illn Inj Sci. 3 (1): 77–87. doi:10.4103/2229-5151.109429. PMC 3665125. PMID 23724391.
↑ Block JA, Sequeira W (June 2001). "Raynaud's phenomenon". Lancet. 357 (9273): 2042–8. doi:10.1016/S0140-6736(00)05118-7. PMID 11438158.
↑ Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N (2008). "Superior vena cava syndrome: A medical emergency?". Int J Angiol. 17 (1): 43–6. PMC 2728369. PMID 22477372.
↑ Fan CM (2005). "Venous pathophysiology". Semin Intervent Radiol. 22 (3): 157–61. doi:10.1055/s-2005-921949. PMC 3036287. PMID 21326688.
↑ Ashurst J, Wasson M (July 2011). "Methemoglobinemia: a systematic review of the pathophysiology, detection, and treatment". Del Med J. 83 (7): 203–8. PMID 21954509.
↑ Spivak JL (February 2002). "The optimal management of polycythaemia vera". Br. J. Haematol. 116 (2): 243–54. PMID 11841424.
↑ Goldman RD (2015). "Breath-holding spells in infants". Can Fam Physician. 61 (2): 149–50. PMC 4325862. PMID 25676645.
↑ Goldenberg MM (2010). "Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment". P T. 35 (7): 392–415. PMC 2912003. PMID 20689626.
↑ Brown EN, Lydic R, Schiff ND (2010). "General anesthesia, sleep, and coma". N Engl J Med. 363 (27): 2638–50. doi:10.1056/NEJMra0808281. PMC 3162622. PMID 21190458.
↑ McAllister TW (2011). "Neurobiological consequences of traumatic brain injury". Dialogues Clin Neurosci. 13 (3): 287–300. PMC 3182015. PMID 22033563.
↑ Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C (January 2018). "Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions". Eur. Heart J. doi:10.1093/eurheartj/ehx720. PMID 29340578.
↑ Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL (2016). "Sepsis and septic shock". Nat Rev Dis Primers. 2: 16045. doi:10.1038/nrdp.2016.45. PMC 5538252. PMID 28117397.
↑ Rehberg S, Maybauer MO, Enkhbaatar P, Maybauer DM, Yamamoto Y, Traber DL (2009). "Pathophysiology, management and treatment of smoke inhalation injury". Expert Rev Respir Med. 3 (3): 283–297. doi:10.1586/ERS.09.21. PMC 2722076. PMID 20161170.
↑ Marriott, Bernadette (1996). Nutritional needs in cold and in high-altitude environments : applications for military personnel in field operations. Washington, D.C: National Academy Press. ISBN 0-309-05484-2.

[Cherry20082-1] Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.

[pmid23162404-2] Abdallah C (2012). "Acute epiglottitis: Trends, diagnosis and management". Saudi J Anaesth. 6 (3): 279–81. doi:10.4103/1658-354X.101222. PMC 3498669. PMID 23162404.

[pmid18682760-3] Qureshi A, Behzadi A (2008). "Foreign-body aspiration in an adult". Can J Surg. 51 (3): E69–70. PMC 2496600. PMID 18682760.

[pmid6869336-4] Liston SL, Gehrz RC, Siegel LG, Tilelli J (August 1983). "Bacterial tracheitis". Am. J. Dis. Child. 137 (8): 764–7. PMID 6869336.

[pmid26336596-5] Spicuzza L, Caruso D, Di Maria G (2015). "Obstructive sleep apnoea syndrome and its management". Ther Adv Chronic Dis. 6 (5): 273–85. doi:10.1177/2040622315590318. PMC 4549693. PMID 26336596.

[pmid23204254-6] Kim V, Criner GJ (2013). "Chronic bronchitis and chronic obstructive pulmonary disease". Am J Respir Crit Care Med. 187 (3): 228–37. doi:10.1164/rccm.201210-1843CI. PMC 4951627. PMID 23204254.

[pmid12531090-7] Peroni DG, Boner AL (September 2000). "Atelectasis: mechanisms, diagnosis and management". Paediatr Respir Rev. 1 (3): 274–8. doi:10.1053/prrv.2000.0059. PMID 12531090.

[pmid1620846-8] Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). "Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT". Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.

[pmid25165554-9] Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.

[pmid19365260-10] Litonjua AA (June 2009). "Childhood asthma may be a consequence of vitamin D deficiency". Curr Opin Allergy Clin Immunol. 9 (3): 202–7. doi:10.1097/ACI.0b013e32832b36cd. PMID 19365260.

[urlCystic_fibrosis_-_Genetics_Home_Reference-11] "Cystic fibrosis - Genetics Home Reference".

[pmid25177479-12] Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.

[OlalekanOluwaseun2015-13] Olalekan, Adebimpe Wasiu; Oluwaseun, Faremi Ayodeji; Oladele, Hassan Abdul-Wasiu; Akeem, Adeyemi Damilare (2015). "Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria". Alexandria Journal of Medicine. 51 (3): 255–260. doi:10.1016/j.ajme.2014.10.003. ISSN 2090-5068.

[pmid29268540-14] Shaw J, Marshall T, Morris H, Hayton C, Chaudhuri N (2017). "Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age". J Thorac Dis. 9 (11): 4700–4707. doi:10.21037/jtd.2017.10.111. PMC 5721024. PMID 29268540.

[pmid27336897-15] Yen CM, Lin CL, Lin MC, Chen HY, Lu NH, Kao CH (2016). "Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study". Medicine (Baltimore). 95 (25): e3972. doi:10.1097/MD.0000000000003972. PMC 4998335. PMID 27336897.

[pmid20493989-16] Hartwig MG, D'Amico TA (June 2010). "Thoracoscopic lobectomy: the gold standard for early-stage lung cancer?". Ann. Thorac. Surg. 89 (6): S2098–101. doi:10.1016/j.athoracsur.2010.02.102. PMID 20493989.

[pmid26045965-17] Ochiai R (2015). "Mechanical ventilation of acute respiratory distress syndrome". J Intensive Care. 3 (1): 25. doi:10.1186/s40560-015-0091-6. PMC 4456061. PMID 26045965.

[pmid23940438-18] Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.

[pmid119300212-19] Khurshid I, Downie GH (2002). "Pulmonary arteriovenous malformation". Postgrad Med J. 78 (918): 191–7. PMC 1742331. PMID 11930021.

[pmid195683982-20] Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G (2009). "Massive spontaneous hemothorax during the immediate postpartum period". Tex Heart Inst J. 36 (3): 247–9. PMC 2696501. PMID 19568398.

[pmid15541322-21] Chanatry BJ (1992). "Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy". Anesth. Analg. 74 (4): 613–5. PMID 1554132.

[pmid28241922-22] Hoeper MM, Ghofrani HA, Grünig E, Klose H, Olschewski H, Rosenkranz S (2017). "Pulmonary Hypertension". Dtsch Arztebl Int. 114 (5): 73–84. doi:10.3238/arztebl.2017.0073. PMC 5331483. PMID 28241922.

[pmid17650694-23] Pettiford BL, Luketich JD, Landreneau RJ (February 2007). "The management of flail chest". Thorac Surg Clin. 17 (1): 25–33. doi:10.1016/j.thorsurg.2007.02.005. PMID 17650694.

[pmid20872980-24] Luh SP (2010). "Review: Diagnosis and treatment of primary spontaneous pneumothorax". J Zhejiang Univ Sci B. 11 (10): 735–44. doi:10.1631/jzus.B1000131. PMC 2950234. PMID 20872980.

[pmid15227445-25] Macris MP, Ott DA, Cooley DA (1992). "Complete atrioventricular canal defect: surgical considerations". Tex Heart Inst J. 19 (3): 239–43. PMC 326195. PMID 15227445.

[pmid27439413-26] Safi LM, Liberthson RR, Bhatt A (September 2016). "Current Management of Ebstein's Anomaly in the Adult". Curr Treat Options Cardiovasc Med. 18 (9): 56. doi:10.1007/s11936-016-0478-2. PMID 27439413.

[pmid19144126-27] Bailliard F, Anderson RH (2009). "Tetralogy of Fallot". Orphanet J Rare Dis. 4: 2. doi:10.1186/1750-1172-4-2. PMC 2651859. PMID 19144126.

[pmid23807889-28] Yoo BW, Park HK (2013). "Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair". Korean J Pediatr. 56 (6): 235–41. doi:10.3345/kjp.2013.56.6.235. PMC 3693041. PMID 23807889.

[pmid17352891-29] Stein P (March 2007). "Total anomalous pulmonary venous connection". AORN J. 85 (3): 509–20, quiz 521–4. doi:10.1016/S0001-2092(07)60123-9. PMID 17352891.

[pmid18851735-30] Martins P, Castela E (2008). "Transposition of the great arteries". Orphanet J Rare Dis. 3: 27. doi:10.1186/1750-1172-3-27. PMC 2577629. PMID 18851735.

[pmid2856609-31] Van Praagh R (1987). "Truncus arteriosus: what is it really and how should it be classified?". Eur J Cardiothorac Surg. 1 (2): 65–70. PMID 2856609.

[urlPatent_Ductus_Arteriosus_-_National_Library_of_Medicine_-_PubMed_Health-32] "Patent Ductus Arteriosus - National Library of Medicine - PubMed Health".

[pmid27367736-33] Inamdar AA, Inamdar AC (2016). "Heart Failure: Diagnosis, Management and Utilization". J Clin Med. 5 (7). doi:10.3390/jcm5070062. PMC 4961993. PMID 27367736.

[pmid20435842-34] Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.

[urlMyocardial_Infarction_(Heart_Attack):_Symptoms_-_National_Library_of_Medicine_-_PubMed_Health-35] "Myocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health".

[pmid22675405-36] Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA; et al. (2012). "Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline". Dtsch Arztebl Int. 109 (19): 343–51. doi:10.3238/arztebl.2012.0343. PMC 3364528. PMID 22675405.

[pmid28912181-37] Marian AJ, Braunwald E (September 2017). "Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy". Circ. Res. 121 (7): 749–770. doi:10.1161/CIRCRESAHA.117.311059. PMID 28912181.

[pmid24717305-38] Hoffmeier A, Sindermann JR, Scheld HH, Martens S (2014). "Cardiac tumors--diagnosis and surgical treatment". Dtsch Arztebl Int. 111 (12): 205–11. doi:10.3238/arztebl.2014.0205. PMC 3983698. PMID 24717305.

[pmid21189882-39] Kannan M, Vijayanand G (2010). "Mitral stenosis and pregnancy: Current concepts in anaesthetic practice". Indian J Anaesth. 54 (5): 439–44. doi:10.4103/0019-5049.71043. PMC 2991654. PMID 21189882.

[pmid24249890-40] Das S, Maiti A (2013). "Acrocyanosis: an overview". Indian J Dermatol. 58 (6): 417–20. doi:10.4103/0019-5154.119946. PMC 3827510. PMID 24249890.

[pmid23724391-41] Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ (2013). "Arterial embolism". Int J Crit Illn Inj Sci. 3 (1): 77–87. doi:10.4103/2229-5151.109429. PMC 3665125. PMID 23724391.

[pmid11438158-42] Block JA, Sequeira W (June 2001). "Raynaud's phenomenon". Lancet. 357 (9273): 2042–8. doi:10.1016/S0140-6736(00)05118-7. PMID 11438158.

[pmid22477372-43] Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N (2008). "Superior vena cava syndrome: A medical emergency?". Int J Angiol. 17 (1): 43–6. PMC 2728369. PMID 22477372.

[pmid21326688-44] Fan CM (2005). "Venous pathophysiology". Semin Intervent Radiol. 22 (3): 157–61. doi:10.1055/s-2005-921949. PMC 3036287. PMID 21326688.

[pmid21954509-45] Ashurst J, Wasson M (July 2011). "Methemoglobinemia: a systematic review of the pathophysiology, detection, and treatment". Del Med J. 83 (7): 203–8. PMID 21954509.

[pmid11841424-46] Spivak JL (February 2002). "The optimal management of polycythaemia vera". Br. J. Haematol. 116 (2): 243–54. PMID 11841424.

[pmid25676645-47] Goldman RD (2015). "Breath-holding spells in infants". Can Fam Physician. 61 (2): 149–50. PMC 4325862. PMID 25676645.

[pmid20689626-48] Goldenberg MM (2010). "Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment". P T. 35 (7): 392–415. PMC 2912003. PMID 20689626.

[pmid21190458-49] Brown EN, Lydic R, Schiff ND (2010). "General anesthesia, sleep, and coma". N Engl J Med. 363 (27): 2638–50. doi:10.1056/NEJMra0808281. PMC 3162622. PMID 21190458.

[pmid22033563-50] McAllister TW (2011). "Neurobiological consequences of traumatic brain injury". Dialogues Clin Neurosci. 13 (3): 287–300. PMC 3182015. PMID 22033563.

[pmid29340578-51] Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C (January 2018). "Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions". Eur. Heart J. doi:10.1093/eurheartj/ehx720. PMID 29340578.

[pmid28117397-52] Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL (2016). "Sepsis and septic shock". Nat Rev Dis Primers. 2: 16045. doi:10.1038/nrdp.2016.45. PMC 5538252. PMID 28117397.

[pmid20161170-53] Rehberg S, Maybauer MO, Enkhbaatar P, Maybauer DM, Yamamoto Y, Traber DL (2009). "Pathophysiology, management and treatment of smoke inhalation injury". Expert Rev Respir Med. 3 (3): 283–297. doi:10.1586/ERS.09.21. PMC 2722076. PMID 20161170.

[54] Marriott, Bernadette (1996). Nutritional needs in cold and in high-altitude environments : applications for military personnel in field operations. Washington, D.C: National Academy Press. ISBN 0-309-05484-2.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

[45]

[46]

[47]

[48]

[49]

[50]

[51]

[52]

[53]

[54]

@@ Line 4: / Line 4: @@
 == Overview ==
-Congenital cyanotic heart disease is a group of heart defects that will causes neonatal cyanosis. The patient appears blue ([[Cyanosis|cyanotic]]), due to deoxygenated [[blood]] bypassing the [[Lung|lungs]] and entering the [[systemic circulation]]. This can be caused by [[Right-to-left shunt|right-to-left]] or [[Bidirectional shunt|bidirectional]] [[Shunt (medical)|shunting]], or malposition of the [[great arteries]]. Such defects include [[persistent truncus arteriosus]], [[total anomalous pulmonary venous connection]], [[tetralogy of Fallot]], [[transposition of the great vessels]], and [[Ebstein's anomaly]].
+Congenital cyanotic heart disease is a group of heart defects that will causes neonatal [[cyanosis]]. The [[patient]] appears blue ([[Cyanosis|cyanotic]]), due to [[deoxygenated blood]] bypassing the [[Lung|lungs]] and entering the [[systemic circulation]]. This can be caused by [[Right-to-left shunt|right-to-left]] or [[Bidirectional shunt|bidirectional]] [[Shunt (medical)|shunting]], or malposition of the [[great arteries]]. Such defects include [[persistent truncus arteriosus]], [[total anomalous pulmonary venous connection]], [[tetralogy of Fallot]], [[transposition of the great vessels]], and [[Ebstein's anomaly]].
 == Classification ==
-Congenital cyanotic heart disease may be classified according to anatomical defect into 5 subgroups:
+Congenital cyanotic heart disease may be classified according to [[Anatomy|anatomical]] [[defect]] into 5 subgroups:
-* Tetralogy of fallot
+*[[Tetralogy of Fallot|Tetralogy of fallot]]
 **It is understood that tetralogy of fallot is the result of improper positioning of the outlet [[septum]].
 **In the normal [[heart]], the outlet septum is an indistinguishable component of the crista supraventricularis that communicates with the [[Septomarginal trabecula|septomarginal trabeculae]] to divide the [[Right ventricle|right]] and [[Left ventricle|left]] [[Ventricle|ventricular cavities]].
@@ Line 17: / Line 17: @@
 **Together, the displacement of the outlet [[septum]] coupled with the [[Hypertrophy (medical)|hypertrophic]] arrangement of the septoparietal trabeculae account for the three [[Anatomy|anatomical]] cardinal [[Defect|defects]] in Tetralogy of Fallot - [[Aorta|aortic]] dextroposition, [[Ventricular septal defect|interventricular communication]] ([[VSD]]), and [[pulmonary stenosis]].
 **The fourth [[defect]] - [[right ventricular hypertrophy]] - is a [[hemodynamic]] consequence of these three [[Morphology|morphologic]] changes, as the [[right ventricle]] physiologically adapts to the increased [[resistance]] of a [[Pulmonary stenosis|stenotic pulmonary trunk]].
-* Total anomalous pulmonary venous connection
+*[[Total anomalous pulmonary venous connection (patient information)|Total anomalous pulmonary venous connection]]
-**n this condition,the right side of heart is receiving blood both from pulmonary and systemic circulation.
+**n this condition,the right side of heart is receiving blood both from [[Pulmonary circulation|pulmonary]] and [[systemic circulation]].
-**There is a mixing of oxygenated pulmonary venous blood with deoxygenated blood from systemic circulation.
+**There is a mixing of oxygenated [[pulmonary]] venous blood with deoxygenated blood from [[systemic circulation]].
-** The mixing of blood could occur at three levels i.e. supracardiac, infracardiac and cardiac.
+** The mixing of [[blood]] could occur at three levels i.e. supracardiac, infracardiac and cardiac.
-**In the former two the mixing occurs outside the heart and in latter inside the heart (right atrium)
+**In the former two the mixing occurs outside the [[heart]] and in latter inside the [[heart]] ([[right atrium]]).
-* Transposition of the great arteries
+*[[Transposition of the great arteries]]
-**In the TGA the [[aorta]] arises from the morphologic [[right ventricle]] via a subaortic infundibulum and the [[pulmonary artery]] arises from the morphologic [[left ventricle]], without a subpulmonary infundibulum.<ref name="pmid17159076">{{cite journal |vauthors=Warnes CA |title=Transposition of the great arteries |journal=Circulation |volume=114 |issue=24 |pages=2699–709 |date=December 2006 |pmid=17159076 |doi=10.1161/CIRCULATIONAHA.105.592352 |url=}}</ref><ref name="Levin1977">{{cite journal|last1=Levin|first1=Daniel L.|title=d-Transposition of the Great Vessels in the Neonate|journal=Archives of Internal Medicine|volume=137|issue=10|year=1977|pages=1421|issn=0003-9926|doi=10.1001/archinte.1977.03630220061015}}</ref><ref name="Rashkind1966">{{cite journal|last1=Rashkind|first1=William J.|title=Creation of an Atrial Septal Defect Without Thoracotomy|journal=JAMA|volume=196|issue=11|year=1966|pages=991|issn=0098-7484|doi=10.1001/jama.1966.03100240125026}}</ref><ref name="pmid10569681">{{cite journal |vauthors=Hornung TS, Bernard EJ, Celermajer DS, Jaeggi E, Howman-Giles RB, Chard RB, Hawker RE |title=Right ventricular dysfunction in congenitally corrected transposition of the great arteries |journal=Am. J. Cardiol. |volume=84 |issue=9 |pages=1116–9, A10 |date=November 1999 |pmid=10569681 |doi=10.1016/s0002-9149(99)00516-0 |url=}}</ref>
+**In the TGA the [[aorta]] arises from the morphologic [[right ventricle]] via a subaortic infundibulum and the [[pulmonary artery]] arises from the morphologic [[left ventricle]], without a subpulmonary infundibulum.
 **These ventriculoarterial connection is known as ventriculoarterial discordance.
 **As a consequence, there is a a fibrous continuity between the mitral and [[pulmonary valve]], but no continuity between the [[tricuspid]] and [[aortic valve]].
-**The abnormal origin of the great arteries results in an altered spiral relationship.
+**The abnormal origin of the [[great arteries]] results in an altered spiral relationship.
-**Therefore, the aorta and pulmonary artery run parallel to each other
+**Therefore, the [[aorta]] and [[pulmonary artery]] run parallel to each other
-**In normal heart thus the circulation is in series.
+**In normal [[heart]] thus the circulation is in series.
-**However, in transposition of the great vessels circulation is in parallel
+**However, in transposition of the great vessels [[circulation]] is in parallel
-* Truncus arteriosus
+*[[Truncus arteriosus]]
-**In truncus arteriosus, the pulmonary arteries are connected to the aorta.
+**In [[truncus arteriosus]], the [[pulmonary arteries]] are connected to the [[aorta]].
-**A decrease in PVR at birth causes a left to right shunt with evidence of congestive heart failure.
+**A decrease in [[PVR]] at birth causes a left to right shunt with evidence of [[congestive heart failure]].
-**These patients have a very high incidence of pulmonary hypertension and vascular disease.
+**These [[Patient|patients]] have a very high [[incidence]] of [[pulmonary hypertension]] and vascular disease.
-* Ebstein's anomaly
+*[[Ebstein's anomaly]]
-**[[Pathophysiology]] mainly involves the [[right ventricle]], [[right atrium]] and [[Tricuspid valves|tricuspid valve]]: <ref name="pmid27541719">{{cite journal |vauthors=Kloesel B, DiNardo JA, Body SC |title=Cardiac Embryology and Molecular Mechanisms of Congenital Heart Disease: A Primer for Anesthesiologists |journal=Anesth. Analg. |volume=123 |issue=3 |pages=551–69 |date=September 2016 |pmid=27541719 |pmc=4996372 |doi=10.1213/ANE.0000000000001451 |url=}}</ref><ref name="pmid21127202">{{cite journal |vauthors=Postma AV, van Engelen K, van de Meerakker J, Rahman T, Probst S, Baars MJ, Bauer U, Pickardt T, Sperling SR, Berger F, Moorman AF, Mulder BJ, Thierfelder L, Keavney B, Goodship J, Klaassen S |title=Mutations in the sarcomere gene MYH7 in Ebstein anomaly |journal=Circ Cardiovasc Genet |volume=4 |issue=1 |pages=43–50 |date=February 2011 |pmid=21127202 |doi=10.1161/CIRCGENETICS.110.957985 |url=}}</ref><ref name="pmid23956225">{{cite journal |vauthors=Bettinelli AL, Mulder TJ, Funke BH, Lafferty KA, Longo SA, Niyazov DM |title=Familial ebstein anomaly, left ventricular hypertrabeculation, and ventricular septal defect associated with a MYH7 mutation |journal=Am. J. Med. Genet. A |volume=161A |issue=12 |pages=3187–90 |date=December 2013 |pmid=23956225 |doi=10.1002/ajmg.a.36182 |url=}}</ref><ref name="pmid31384377">{{cite journal |vauthors=Holst KA, Connolly HM, Dearani JA |title=Ebstein's Anomaly |journal=Methodist Debakey Cardiovasc J |volume=15 |issue=2 |pages=138–144 |date=2019 |pmid=31384377 |pmc=6668741 |doi=10.14797/mdcj-15-2-138 |url=}}</ref>
+**[[Pathophysiology]] mainly involves the [[right ventricle]], [[right atrium]] and [[Tricuspid valves|tricuspid valve]]:
 *** Failure of TV([[Tricuspid valves|tricuspid valve]]) leaflet delamination
 *** Apical descent of the functional [[Tricuspid|tricuspid orifice]]
-*** [[Right ventricular dilation]] and “atrialization”
+***[[Right ventricular dilation]] and “atrialization”
 *** Anterior leaflet abnormal [[fenestrations]] and tethering
-*** [[Right atrioventricular orifice|Right atrioventricular junction]] dilation
+***[[Right atrioventricular orifice|Right atrioventricular junction]] dilation
 == Differential diagnosis ==
@@ Line 77: / Line 77: @@
 ! rowspan="20" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary disease|Pulmonary diseases]]
 ! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Airway]] disorder
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]]<ref name="Cherry20082">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 96: / Line 96: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Intercostal]] and [[subcostal]] [[retraction]], [[Barking cough]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]<ref name="pmid23162404">{{cite journal| author=Abdallah C| title=Acute epiglottitis: Trends, diagnosis and management. | journal=Saudi J Anaesth | year= 2012 | volume= 6 | issue= 3 | pages= 279-81 | pmid=23162404 | doi=10.4103/1658-354X.101222 | pmc=3498669 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23162404  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 115: / Line 115: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Muffled voice, [[Drooling]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]<ref name="pmid18682760">{{cite journal| author=Qureshi A, Behzadi A| title=Foreign-body aspiration in an adult. | journal=Can J Surg | year= 2008 | volume= 51 | issue= 3 | pages= E69-70 | pmid=18682760 | doi= | pmc=2496600 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18682760  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 134: / Line 134: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Mediastinitis]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]<ref name="pmid6869336">{{cite journal |vauthors=Liston SL, Gehrz RC, Siegel LG, Tilelli J |title=Bacterial tracheitis |journal=Am. J. Dis. Child. |volume=137 |issue=8 |pages=764–7 |date=August 1983 |pmid=6869336 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 153: / Line 153: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Brassy [[cough]], [[Hoarseness]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Sleep apnea]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Sleep apnea]]<ref name="pmid26336596">{{cite journal| author=Spicuzza L, Caruso D, Di Maria G| title=Obstructive sleep apnoea syndrome and its management. | journal=Ther Adv Chronic Dis | year= 2015 | volume= 6 | issue= 5 | pages= 273-85 | pmid=26336596 | doi=10.1177/2040622315590318 | pmc=4549693 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26336596  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 172: / Line 172: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Nightmares]], [[Snoring]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Chronic [[bronchitis]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Chronic [[bronchitis]]<ref name="pmid23204254">{{cite journal| author=Kim V, Criner GJ| title=Chronic bronchitis and chronic obstructive pulmonary disease. | journal=Am J Respir Crit Care Med | year= 2013 | volume= 187 | issue= 3 | pages= 228-37 | pmid=23204254 | doi=10.1164/rccm.201210-1843CI | pmc=4951627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23204254  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 191: / Line 191: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Productive cough]], [[Chest tightness]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atelectasis]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atelectasis]]<ref name="pmid12531090">{{cite journal |vauthors=Peroni DG, Boner AL |title=Atelectasis: mechanisms, diagnosis and management |journal=Paediatr Respir Rev |volume=1 |issue=3 |pages=274–8 |date=September 2000 |pmid=12531090 |doi=10.1053/prrv.2000.0059 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 211: / Line 211: @@
 |-
 ! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Parenchymal lung disease|Parenchymal disorder]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Alveolitis]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Alveolitis]]<ref name="pmid1620846">{{cite journal |vauthors=Lee JS, Im JG, Ahn JM, Kim YM, Han MC |title=Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT |journal=Radiology |volume=184 |issue=2 |pages=451–4 |date=August 1992 |pmid=1620846 |doi=10.1148/radiology.184.2.1620846 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 230: / Line 230: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Malaise]], [[Chills]], [[Headache]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 249: / Line 249: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Bradycardia]] ([[Legionella]])
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late)
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late)<ref name="pmid19365260">{{cite journal |vauthors=Litonjua AA |title=Childhood asthma may be a consequence of vitamin D deficiency |journal=Curr Opin Allergy Clin Immunol |volume=9 |issue=3 |pages=202–7 |date=June 2009 |pmid=19365260 |doi=10.1097/ACI.0b013e32832b36cd |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 268: / Line 268: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Triad of [[asthma]], [[nasal polyps]], and [[rash]] is indicative of [[Aspirin desensitization|aspirin sensitivity]].
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]]<ref name="urlCystic fibrosis - Genetics Home Reference">{{cite web |url=https://ghr.nlm.nih.gov/condition/cystic-fibrosis |title=Cystic fibrosis - Genetics Home Reference |format= |work= |accessdate=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 288: / Line 288: @@
 |-
 ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[COPD]]
-(Severe [[emphysema]])
+(Severe [[emphysema]])<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 307: / Line 307: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pulmonary hypertension]], [[Right heart failure]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tuberculosis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tuberculosis]]<ref name="OlalekanOluwaseun2015">{{cite journal|last1=Olalekan|first1=Adebimpe Wasiu|last2=Oluwaseun|first2=Faremi Ayodeji|last3=Oladele|first3=Hassan Abdul-Wasiu|last4=Akeem|first4=Adeyemi Damilare|title=Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria|journal=Alexandria Journal of Medicine|volume=51|issue=3|year=2015|pages=255–260|issn=20905068|doi=10.1016/j.ajme.2014.10.003}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 326: / Line 326: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Loss of appetite]], [[Night sweats]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary fibrosis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary fibrosis]]<ref name="pmid29268540">{{cite journal| author=Shaw J, Marshall T, Morris H, Hayton C, Chaudhuri N| title=Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age. | journal=J Thorac Dis | year= 2017 | volume= 9 | issue= 11 | pages= 4700-4707 | pmid=29268540 | doi=10.21037/jtd.2017.10.111 | pmc=5721024 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29268540  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 347: / Line 347: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Weight loss]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumoconiosis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumoconiosis]]<ref name="pmid27336897">{{cite journal| author=Yen CM, Lin CL, Lin MC, Chen HY, Lu NH, Kao CH| title=Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 25 | pages= e3972 | pmid=27336897 | doi=10.1097/MD.0000000000003972 | pmc=4998335 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27336897  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 368: / Line 368: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tightness in the [[chest]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lung cancer]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lung cancer]]<ref name="pmid20493989">{{cite journal |vauthors=Hartwig MG, D'Amico TA |title=Thoracoscopic lobectomy: the gold standard for early-stage lung cancer? |journal=Ann. Thorac. Surg. |volume=89 |issue=6 |pages=S2098–101 |date=June 2010 |pmid=20493989 |doi=10.1016/j.athoracsur.2010.02.102 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 391: / Line 391: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Weight loss]], [[Loss of appetite]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute respiratory distress syndrome]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute respiratory distress syndrome]]<ref name="pmid26045965">{{cite journal| author=Ochiai R| title=Mechanical ventilation of acute respiratory distress syndrome. | journal=J Intensive Care | year= 2015 | volume= 3 | issue= 1 | pages= 25 | pmid=26045965 | doi=10.1186/s40560-015-0091-6 | pmc=4456061 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26045965  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 411: / Line 411: @@
 |-
 ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary vascular congestion|Pulmonary vascular disorders]]
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]]<ref name="pmid23940438">{{cite journal| author=Bĕlohlávek J, Dytrych V, Linhart A| title=Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 129-38 | pmid=23940438 | doi= | pmc=3718593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940438  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 430: / Line 430: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Shock]], [[Pulmonary hypertension]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary arterio-venous malformation]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary arterio-venous malformation]]<ref name="pmid119300212">{{cite journal |vauthors=Khurshid I, Downie GH |title=Pulmonary arteriovenous malformation |journal=Postgrad Med J |volume=78 |issue=918 |pages=191–7 |year=2002 |pmid=11930021 |pmc=1742331 |doi= |url=}}</ref><ref name="pmid195683982">{{cite journal |vauthors=Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G |title=Massive spontaneous hemothorax during the immediate postpartum period |journal=Tex Heart Inst J |volume=36 |issue=3 |pages=247–9 |year=2009 |pmid=19568398 |pmc=2696501 |doi= |url=}}</ref><ref name="pmid15541322">{{cite journal |vauthors=Chanatry BJ |title=Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy |journal=Anesth. Analg. |volume=74 |issue=4 |pages=613–5 |year=1992 |pmid=1554132 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 449: / Line 449: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cerebral arteriovenous malformation]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary hypertension]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary hypertension]]<ref name="pmid28241922">{{cite journal| author=Hoeper MM, Ghofrani HA, Grünig E, Klose H, Olschewski H, Rosenkranz S| title=Pulmonary Hypertension. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 5 | pages= 73-84 | pmid=28241922 | doi=10.3238/arztebl.2017.0073 | pmc=5331483 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28241922  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 471: / Line 471: @@
 |-
 ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chest wall deformities|Chest wall disorders]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]]<ref name="pmid17650694">{{cite journal |vauthors=Pettiford BL, Luketich JD, Landreneau RJ |title=The management of flail chest |journal=Thorac Surg Clin |volume=17 |issue=1 |pages=25–33 |date=February 2007 |pmid=17650694 |doi=10.1016/j.thorsurg.2007.02.005 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 490: / Line 490: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bruises]] over [[chest]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]<ref name="pmid20872980">{{cite journal| author=Luh SP| title=Review: Diagnosis and treatment of primary spontaneous pneumothorax. | journal=J Zhejiang Univ Sci B | year= 2010 | volume= 11 | issue= 10 | pages= 735-44 | pmid=20872980 | doi=10.1631/jzus.B1000131 | pmc=2950234 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20872980  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 530: / Line 530: @@
 ! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiac disease|Cardiac diseases]]
 ! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Congenital disorder|Congenital disorders]]
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]]<ref name="pmid15227445">{{cite journal| author=Macris MP, Ott DA, Cooley DA| title=Complete atrioventricular canal defect: surgical considerations. | journal=Tex Heart Inst J | year= 1992 | volume= 19 | issue= 3 | pages= 239-43 | pmid=15227445 | doi= | pmc=326195 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15227445  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 549: / Line 549: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], Lack of [[appetite]], [[Pale skin color]], Excessive [[sweating]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ebstein anomaly]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ebstein anomaly]]<ref name="pmid27439413">{{cite journal |vauthors=Safi LM, Liberthson RR, Bhatt A |title=Current Management of Ebstein's Anomaly in the Adult |journal=Curr Treat Options Cardiovasc Med |volume=18 |issue=9 |pages=56 |date=September 2016 |pmid=27439413 |doi=10.1007/s11936-016-0478-2 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 568: / Line 568: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Palpitations]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tetralogy of Fallot]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tetralogy of Fallot]]<ref name="pmid19144126">{{cite journal| author=Bailliard F, Anderson RH| title=Tetralogy of Fallot. | journal=Orphanet J Rare Dis | year= 2009 | volume= 4 | issue=  | pages= 2 | pmid=19144126 | doi=10.1186/1750-1172-4-2 | pmc=2651859 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19144126  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 587: / Line 587: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonic stenosis]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonic stenosis]]<ref name="pmid23807889">{{cite journal| author=Yoo BW, Park HK| title=Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair. | journal=Korean J Pediatr | year= 2013 | volume= 56 | issue= 6 | pages= 235-41 | pmid=23807889 | doi=10.3345/kjp.2013.56.6.235 | pmc=3693041 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23807889  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 606: / Line 606: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Total anomalous pulmonary venous drainage|Total anomalous pulmonary]] [[Total anomalous pulmonary venous drainage|venous connection]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Total anomalous pulmonary venous drainage|Total anomalous pulmonary]] [[Total anomalous pulmonary venous drainage|venous connection]]<ref name="pmid17352891">{{cite journal |vauthors=Stein P |title=Total anomalous pulmonary venous connection |journal=AORN J |volume=85 |issue=3 |pages=509–20; quiz 521–4 |date=March 2007 |pmid=17352891 |doi=10.1016/S0001-2092(07)60123-9 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 625: / Line 625: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Pounding [[heart]], Weak [[pulse]], Extreme [[sleepiness]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Transposition of the great vessels]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Transposition of the great vessels]]<ref name="pmid18851735">{{cite journal| author=Martins P, Castela E| title=Transposition of the great arteries. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue=  | pages= 27 | pmid=18851735 | doi=10.1186/1750-1172-3-27 | pmc=2577629 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18851735  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 644: / Line 644: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lack of appetite]], [[Poor weight gain]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Truncus arteriosus]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Truncus arteriosus]]<ref name="pmid2856609">{{cite journal |vauthors=Van Praagh R |title=Truncus arteriosus: what is it really and how should it be classified? |journal=Eur J Cardiothorac Surg |volume=1 |issue=2 |pages=65–70 |date=1987 |pmid=2856609 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 663: / Line 663: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Sweating]], [[Pale skin|Pale]] or cool [[skin]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Patent ductus arteriosus]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Patent ductus arteriosus]]<ref name="urlPatent Ductus Arteriosus - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023293/. |title=Patent Ductus Arteriosus - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 683: / Line 683: @@
 |-
 ! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acquired disorder|Acquired disorders]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]]<ref name="pmid27367736">{{cite journal| author=Inamdar AA, Inamdar AC| title=Heart Failure: Diagnosis, Management and Utilization. | journal=J Clin Med | year= 2016 | volume= 5 | issue= 7 | pages=  | pmid=27367736 | doi=10.3390/jcm5070062 | pmc=4961993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27367736  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 702: / Line 702: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Generalized edema]], [[Hepatomegaly]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Valvular heart disease]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Valvular heart disease]]<ref name="pmid20435842">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 721: / Line 721: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Palpitation]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial infarction]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial infarction]]<ref name="urlMyocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023216/ |title=Myocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 740: / Line 740: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Fatigue]], [[Lightheadedness]], [[Cold sweat]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiogenic shock]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiogenic shock]]<ref name="pmid22675405">{{cite journal| author=Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA et al.| title=Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline. | journal=Dtsch Arztebl Int | year= 2012 | volume= 109 | issue= 19 | pages= 343-51 | pmid=22675405 | doi=10.3238/arztebl.2012.0343 | pmc=3364528 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22675405  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 759: / Line 759: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], [[Palpitation]], [[Hypotension]], Weak [[pulse]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiomyopathy]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiomyopathy]]<ref name="pmid28912181">{{cite journal |vauthors=Marian AJ, Braunwald E |title=Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy |journal=Circ. Res. |volume=121 |issue=7 |pages=749–770 |date=September 2017 |pmid=28912181 |doi=10.1161/CIRCRESAHA.117.311059 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 778: / Line 778: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Arrhythmias|Arrhythmia]], [[Bloating]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart tumors]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart tumors]]<ref name="pmid24717305">{{cite journal| author=Hoffmeier A, Sindermann JR, Scheld HH, Martens S| title=Cardiac tumors--diagnosis and surgical treatment. | journal=Dtsch Arztebl Int | year= 2014 | volume= 111 | issue= 12 | pages= 205-11 | pmid=24717305 | doi=10.3238/arztebl.2014.0205 | pmc=3983698 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24717305  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 797: / Line 797: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Weight loss]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mitral Stenosis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mitral Stenosis]]<ref name="pmid21189882">{{cite journal| author=Kannan M, Vijayanand G| title=Mitral stenosis and pregnancy: Current concepts in anaesthetic practice. | journal=Indian J Anaesth | year= 2010 | volume= 54 | issue= 5 | pages= 439-44 | pmid=21189882 | doi=10.4103/0019-5049.71043 | pmc=2991654 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21189882  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 818: / Line 818: @@
 ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Vascular disease]]
 ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial Insufficiency|Arterial disorders]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ddx:Acrocyanosis|Acrocyanosis]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ddx:Acrocyanosis|Acrocyanosis]]<ref name="pmid24249890">{{cite journal| author=Das S, Maiti A| title=Acrocyanosis: an overview. | journal=Indian J Dermatol | year= 2013 | volume= 58 | issue= 6 | pages= 417-20 | pmid=24249890 | doi=10.4103/0019-5154.119946 | pmc=3827510 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24249890  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 837: / Line 837: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Brittle nails]], [[Telangiectasia]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial embolism]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial embolism]]<ref name="pmid23724391">{{cite journal| author=Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ| title=Arterial embolism. | journal=Int J Crit Illn Inj Sci | year= 2013 | volume= 3 | issue= 1 | pages= 77-87 | pmid=23724391 | doi=10.4103/2229-5151.109429 | pmc=3665125 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23724391  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 856: / Line 856: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], Decreased [[sensation]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Raynaud's Phenomenon]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Raynaud's Phenomenon]]<ref name="pmid11438158">{{cite journal |vauthors=Block JA, Sequeira W |title=Raynaud's phenomenon |journal=Lancet |volume=357 |issue=9273 |pages=2042–8 |date=June 2001 |pmid=11438158 |doi=10.1016/S0140-6736(00)05118-7 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 876: / Line 876: @@
 |-
 ! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous insufficiency|Venous disorders]]
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Superior vena cava obstruction]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Superior vena cava obstruction]]<ref name="pmid22477372">{{cite journal| author=Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N| title=Superior vena cava syndrome: A medical emergency? | journal=Int J Angiol | year= 2008 | volume= 17 | issue= 1 | pages= 43-6 | pmid=22477372 | doi= | pmc=2728369 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22477372  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 897: / Line 897: @@
 [[Facial]] [[swelling]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous stasis]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous stasis]]<ref name="pmid21326688">{{cite journal| author=Fan CM| title=Venous pathophysiology. | journal=Semin Intervent Radiol | year= 2005 | volume= 22 | issue= 3 | pages= 157-61 | pmid=21326688 | doi=10.1055/s-2005-921949 | pmc=3036287 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21326688  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 938: / Line 938: @@
 |-
 ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hematologic diseases]]
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Methemoglobinemia]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Methemoglobinemia]]<ref name="pmid21954509">{{cite journal |vauthors=Ashurst J, Wasson M |title=Methemoglobinemia: a systematic review of the pathophysiology, detection, and treatment |journal=Del Med J |volume=83 |issue=7 |pages=203–8 |date=July 2011 |pmid=21954509 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 957: / Line 957: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], [[Altered mental status]], [[Delirium]], [[Seizure]], [[Coma]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polycythemia]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polycythemia]]<ref name="pmid11841424">{{cite journal |vauthors=Spivak JL |title=The optimal management of polycythaemia vera |journal=Br. J. Haematol. |volume=116 |issue=2 |pages=243–54 |date=February 2002 |pmid=11841424 |doi= |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 977: / Line 977: @@
 |-
 ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Breath-holding spells]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Breath-holding spells]]<ref name="pmid25676645">{{cite journal| author=Goldman RD| title=Breath-holding spells in infants. | journal=Can Fam Physician | year= 2015 | volume= 61 | issue= 2 | pages= 149-50 | pmid=25676645 | doi= | pmc=4325862 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25676645  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 996: / Line 996: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Twitching|Twitching muscles]], [[Seizure]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure]]<ref name="pmid20689626">{{cite journal| author=Goldenberg MM| title=Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment. | journal=P T | year= 2010 | volume= 35 | issue= 7 | pages= 392-415 | pmid=20689626 | doi= | pmc=2912003 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20689626  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 1,015: / Line 1,015: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Tonic-clonic|Tonic-clonic movements]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]<ref name="pmid21190458">{{cite journal| author=Brown EN, Lydic R, Schiff ND| title=General anesthesia, sleep, and coma. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 27 | pages= 2638-50 | pmid=21190458 | doi=10.1056/NEJMra0808281 | pmc=3162622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21190458  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 1,034: / Line 1,034: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Depressed [[brainstem]] reflexes, [[Agonal breathing]]
 |-
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Head trauma]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Head trauma]]<ref name="pmid22033563">{{cite journal| author=McAllister TW| title=Neurobiological consequences of traumatic brain injury. | journal=Dialogues Clin Neurosci | year= 2011 | volume= 13 | issue= 3 | pages= 287-300 | pmid=22033563 | doi= | pmc=3182015 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22033563  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 1,054: / Line 1,054: @@
 |-
 ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous
-! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[High altitude exposure]]
+! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[High altitude exposure]]<ref name="pmid29340578">{{cite journal |vauthors=Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C |title=Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions |journal=Eur. Heart J. |volume= |issue= |pages= |date=January 2018 |pmid=29340578 |doi=10.1093/eurheartj/ehx720 |url=}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 1,073: / Line 1,073: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Coma]],  Death
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Septic shock]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Septic shock]]<ref name="pmid28117397">{{cite journal| author=Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL| title=Sepsis and septic shock. | journal=Nat Rev Dis Primers | year= 2016 | volume= 2 | issue=  | pages= 16045 | pmid=28117397 | doi=10.1038/nrdp.2016.45 | pmc=5538252 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28117397  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
@@ Line 1,092: / Line 1,092: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Chills]], [[Hypothermia]], [[Loss of consciousness]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Smoke inhalation]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Smoke inhalation]]<ref name="pmid20161170">{{cite journal| author=Rehberg S, Maybauer MO, Enkhbaatar P, Maybauer DM, Yamamoto Y, Traber DL| title=Pathophysiology, management and treatment of smoke inhalation injury. | journal=Expert Rev Respir Med | year= 2009 | volume= 3 | issue= 3 | pages= 283-297 | pmid=20161170 | doi=10.1586/ERS.09.21 | pmc=2722076 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20161170  }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/-
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
@@ Line 1,111: / Line 1,111: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cough]], [[Hoarseness]], [[Hemoptysis]], [[Headache]], [[Fainting]]
 |-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cold exposure]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cold exposure]]<ref>{{cite book | last = Marriott | first = Bernadette | title = Nutritional needs in cold and in high-altitude environments : applications for military personnel in field operations | publisher = National Academy Press | location = Washington, D.C | year = 1996 | isbn = 0-309-05484-2 }}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | -