Ebsteins anomaly of the tricuspid valve differential diagnosis: Difference between revisions

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__NOTOC__
{{Template:ebstein's anomaly of the tricuspid valve}}
{{Template:ebstein's anomaly of the tricuspid valve}}
{{CMG}} and Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]
{{CMG}} '''Associate Editor-In-Chief:''' {{CZ}}; Claudia P. Hochberg, M.D.{{M.N}}
__NOTOC__
'''Associate Editor-In-Chief:''' {{CZ}}
 
== Ebstein's anomaly of the tricuspid valve should be distinguished from ==


==Overview==
Disorders that Ebstein's anomaly must be distinguished from include:
* Accessory pathway-mediated [[WPW syndrome]] and [[SVT]]
* Accessory pathway-mediated [[WPW syndrome]] and [[SVT]]
* [[Atrial septal defect]] ([[ASD]])
* [[Atrial septal defect]] ([[ASD]])
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* [[Isolated, severe tricuspid regurgitation]]
* [[Isolated, severe tricuspid regurgitation]]
* [[L-transposition of the great vessels]]
* [[L-transposition of the great vessels]]
* [[Severe right heart failure]]
* [[Severe right heart failure]] with dilation of the anulus
 
==Differentiating Ebsteins anomaly of the tricuspid valve from other diseases==
Ebstein's anomaly should be differentiated from other cynotic diseases and others<ref name="pmid25945265">{{cite journal |vauthors=Zuberi SA, Liu S, Tam JW, Hussain F, Maguire D, Kass M |title=Partial PFO Closure for Persistent Hypoxemia in a Patient with Ebstein Anomaly |journal=Case Rep Cardiol |volume=2015 |issue= |pages=531382 |date=2015 |pmid=25945265 |pmc=4405015 |doi=10.1155/2015/531382 |url=}}</ref><ref name="pmid22723533">{{cite journal |vauthors=Kilner PJ |title=Imaging congenital heart disease in adults |journal=Br J Radiol |volume=84 Spec No 3 |issue= |pages=S258–68 |date=December 2011 |pmid=22723533 |pmc=3473918 |doi=10.1259/bjr/74240815 |url=}}</ref><ref name="pmid24294540">{{cite journal |vauthors=Romfh A, Pluchinotta FR, Porayette P, Valente AM, Sanders SP |title=Congenital Heart Defects in Adults : A Field Guide for Cardiologists |journal=J Clin Exp Cardiolog |volume= |issue=Suppl 8 |pages= |date=June 2012 |pmid=24294540 |pmc=3842121 |doi=10.4172/2155-9880.s8-007 |url=}}</ref>
 
{| class="wikitable"
|+
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disorders
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Etiology
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical Presentation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Laboratory Findings
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Electrocardiogram
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography
|-
|[[Tetralogy of Fallot]]
|Multifactorial
 
* [[Polymorphism (biology)|Genetic polymorphisms]]
* Maternal [[rubella]]
* Poor prenatal nutrition
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
|
* [[Cyanosis]] on exertion
* [[Exertional dyspnea]]
* [[Palpitation|Palpitations]]
* [[Fatigue]]
|
* CBC: [[Anemia]] or [[polycythemia]].
* [[Coagulation]] profile.
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
|
*[[Right ventricular hypertrophy]]
*[[Right bundle branch block]]
*[[Tachycardia]]
* Rate of [[QRS complex|QRS]] change predicts [[Ventricular arrhythmias|ventricular arrhythmia]]
|[[Echocardiography]] may show:
 
* Residual [[Ventricular septal defect|VSD]] or [[Atrial septal defect|ASD]]
* RV outflow tract obstruction
* Abnormal valvular anatomy
|-
|[[Total anomalous pulmonary venous connection|Total Anomalous Pulmonary Venous Connection]]
|Multifactorial
 
*[[Polymorphism (biology)|Genetic polymorphisms]]
* Maternal [[rubella]]
* Poor prenatal nutrition
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
|
* [[Tachypnea]]
* [[Palpitation|Palpitations]]
* [[Cyanosis]]
* [[Failure to thrive]]
|
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
* [[Coagulation]] profile.
|
* [[Right ventricular hypertrophy]] with a qR pattern
|
*[[Right ventricular hypertrophy]]
*Right ventricular loading
*Paradoxical septal motion
*
|-
|[[Tricuspid atresia|Tricuspid Atresia]]
|Multifactorial
 
*[[Polymorphism (biology)|Genetic polymorphisms]]
* Maternal [[rubella]]
* Poor prenatal nutrition
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
|
* Respiratory difficulties  as nasal flaring or muscle retractions
* [[Cyanosis]]
* Growth retradation
|
* [[Arterial blood gas|Arterial blood gases]]
* [[Complete blood count|CBC]]: [[Polycythemia]]
* [[Coagulation]] profile
|
* Tall [[P wave|P waves]] indicate atrial enlargement.
 
* First-degree [[atrioventricular block]].
 
* Frontal plane [[QRS complex|QRS]] axis may be leftward.
|Echocardiography may show
 
* Defect size
* Pulmonary [[blood flow]]
*[[Ventricular function]]
* Valve abnormalities
|-
|[[Transposition of the great vessels|Transposition of the Great Arteries]]
|Multifactorial
 
*[[Polymorphism (biology)|Genetic polymorphisms]]
* Poor prenatal nutrition
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
|
* Prominent [[cyanosis]] within hours of birth
*[[Congestive heart failure]]
*
|
*[[Arterial blood gas|Arterial blood gases]]: [[Hypoxemia]]
* Hyperoxia test
|
* [[Right ventricular hypertrophy]]
 
* [[Right axis deviation]]
* Varying degrees of [[Atrioventricular block|AV block]]
 
* [[Q waves]]
|[[Echocardiography]] may show:


* Relationship between [[great vessels]]
* Associated anatomic lesions
* [[Coronary artery]] origin and branches
|}


==References==
==References==
{{Reflist}}
{{Reflist}}


{{WH}}


{{Congenital malformations and deformations of circulatory system}}
{{WS}}
[[Category:DiseaseState]]
 
[[Category:Cardiovascular system]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
 
[[Category:Disease]]
{{WH}}
 
{{WS}}

Latest revision as of 22:38, 7 July 2020

Ebsteins anomaly of the tricuspid valve Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Claudia P. Hochberg, M.D. Maneesha Nandimandalam, M.B.B.S.[3]

Overview

Disorders that Ebstein's anomaly must be distinguished from include:

Differentiating Ebsteins anomaly of the tricuspid valve from other diseases

Ebstein's anomaly should be differentiated from other cynotic diseases and others[1][2][3]

Disorders Etiology Clinical Presentation Laboratory Findings Electrocardiogram Echocardiography
Tetralogy of Fallot Multifactorial Echocardiography may show:
  • Residual VSD or ASD
  • RV outflow tract obstruction
  • Abnormal valvular anatomy
Total Anomalous Pulmonary Venous Connection Multifactorial
Tricuspid Atresia Multifactorial
  • Respiratory difficulties as nasal flaring or muscle retractions
  • Cyanosis
  • Growth retradation
  • Tall P waves indicate atrial enlargement.
  • Frontal plane QRS axis may be leftward.
 Echocardiography may show
Transposition of the Great Arteries Multifactorial Echocardiography may show:

References

  1. ↑ Zuberi SA, Liu S, Tam JW, Hussain F, Maguire D, Kass M (2015). "Partial PFO Closure for Persistent Hypoxemia in a Patient with Ebstein Anomaly". Case Rep Cardiol. 2015: 531382. doi:10.1155/2015/531382. PMC 4405015. PMID 25945265.
  2. ↑ Kilner PJ (December 2011). "Imaging congenital heart disease in adults". Br J Radiol. 84 Spec No 3: S258–68. doi:10.1259/bjr/74240815. PMC 3473918. PMID 22723533.
  3. ↑ Romfh A, Pluchinotta FR, Porayette P, Valente AM, Sanders SP (June 2012). "Congenital Heart Defects in Adults : A Field Guide for Cardiologists". J Clin Exp Cardiolog (Suppl 8). doi:10.4172/2155-9880.s8-007. PMC 3842121. PMID 24294540.

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