Tricuspid atresia differential diagnosis: Difference between revisions

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Latest revision as of 15:52, 8 November 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Zand, M.D.[2] Keri Shafer, M.D. [3] Priyamvada Singh, MBBS [4]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

Patients with tricuspid atresia should be differentiated from other cardiac causes of cyanosis and lung olygemia include:Tetralogy of Fallot, Truncus arteriosus, Total anomalous pulmonary venous connection, Pulmonary atresia, Tricuspid stenosis.

Differentiating tricuspid atresia from other Diseases

Patients with tricuspid atresia should be differentiated from other cardiac causes of cyanosis and lung olygemia include:

Table below compares cyanotic heart diseases:^[1]^[2]^[3]^[4]


Disorders	Etiology	Clinical Presentation	Laboratory Findings	Electrocardiogram Findings	Echocardiography Findings	X-Ray Findings
Tetralogy of Fallot	Multifactorial Genetic polymorphisms Maternal rubella Poor prenatal nutrition Maternal alcohol use Maternal diabetes	Cyanosis on exertion Exertional dyspnea 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 change predicts ventricular arrhythmia	Echocardiography may show: Residual VSD or ASD RV outflow tract obstruction Abnormal valvular anatomy	The boot-shaped heart appearance Normal heart size Pulmonary vascular marking may be normal or decreased
Total Anomalous Pulmonary Venous Connection	Multifactorial Genetic polymorphisms Maternal rubella Poor prenatal nutrition Maternal alcohol use Maternal diabetes	Tachypnea 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	Prominence of the pulmonary arteries Mild enlargement of heart The classic snowman sign is seen in supracardiac subtype
Tricuspid Atresia	Multifactorial 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 gases CBC: Polycythemia Coagulation profile	Tall P waves indicate atrial enlargement. First-degree atrioventricular block. Frontal plane QRS axis may be leftward.	Echocardiography may show Defect size Pulmonary blood flow Ventricular function Valve abnormalities	Smooth convexity of right heart border is absent Lower part of right heart border is limited to the spine Prominency of the pulmonary artery depends on their blood flow Cardiac size may be normal or enlarged
Transposition of the Great Arteries	Multifactorial Genetic polymorphisms Poor prenatal nutrition Maternal alcohol use Maternal diabetes	Prominent cyanosis within hours of birth Congestive heart failure	Arterial blood gases: Hypoxemia Hyperoxia test	Right ventricular hypertrophy Right axis deviation Varying degrees of AV block Q waves	Echocardiography may show: Relationship between great vessels Associated anatomic lesions Coronary artery origin and branches	The classic egg on string appearance Pulmonary vascular marking may be normal or increased

References

↑ Bailliard F, Anderson RH (January 2009). "Tetralogy of Fallot". Orphanet J Rare Dis. 4: 2. doi:10.1186/1750-1172-4-2. PMC 2651859. PMID 19144126.
↑ Kao CC, Hsieh CC, Cheng PJ, Chiang CH, Huang SY (2017). "Total Anomalous Pulmonary Venous Connection: From Embryology to a Prenatal Ultrasound Diagnostic Update". J Med Ultrasound. 25 (3): 130–137. doi:10.1016/j.jmu.2017.08.002. PMC 6029298. PMID 30065477.
↑ ASTLEY R, OLDHAM JS, PARSONS C (July 1953). "Congenital tricuspid atresia". Br Heart J. 15 (3): 287–97. doi:10.1136/hrt.15.3.287. PMC 479498. PMID 13059216.
↑ Unolt M, Putotto C, Silvestri LM, Marino D, Scarabotti A, Valerio M, Caiaro A, Versacci P, Marino B (June 2013). "Transposition of great arteries: new insights into the pathogenesis". Front Pediatr. 1: 11. doi:10.3389/fped.2013.00011. PMC 3860888. PMID 24400257. Vancouver style error: initials (help)

Template:WH Template:WS

[pmid19144126-1] Bailliard F, Anderson RH (January 2009). "Tetralogy of Fallot". Orphanet J Rare Dis. 4: 2. doi:10.1186/1750-1172-4-2. PMC 2651859. PMID 19144126.

[pmid30065477-2] Kao CC, Hsieh CC, Cheng PJ, Chiang CH, Huang SY (2017). "Total Anomalous Pulmonary Venous Connection: From Embryology to a Prenatal Ultrasound Diagnostic Update". J Med Ultrasound. 25 (3): 130–137. doi:10.1016/j.jmu.2017.08.002. PMC 6029298. PMID 30065477.

[pmid13059216-3] ASTLEY R, OLDHAM JS, PARSONS C (July 1953). "Congenital tricuspid atresia". Br Heart J. 15 (3): 287–97. doi:10.1136/hrt.15.3.287. PMC 479498. PMID 13059216.

[pmid24400257-4] Unolt M, Putotto C, Silvestri LM, Marino D, Scarabotti A, Valerio M, Caiaro A, Versacci P, Marino B (June 2013). "Transposition of great arteries: new insights into the pathogenesis". Front Pediatr. 1: 11. doi:10.3389/fped.2013.00011. PMC 3860888. PMID 24400257. Vancouver style error: initials (help)

[1]

[2]

[3]

[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Template:Tricuspid atresia}}
-{{CMG}}; '''Associate Editor-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [[mailto:psingh@perfuse.org]]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@perfuse.org]]
+{{CMG}}; '''Associate Editor-In-Chief:''' {{Sara.Zand}} [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]
+==Overview==
+Patients with [[tricuspid atresia]] should be differentiated from other [[cardiac]] causes of [[cyanosis]] and [[lung]] olygemia include:[[Tetralogy of Fallot]], [[Truncus arteriosus]], [[Total anomalous pulmonary venous connection]], [[Pulmonary atresia]], [[Tricuspid stenosis]].
+== Differentiating tricuspid atresia from other Diseases ==
-==Overview==
+Patients with [[tricuspid atresia]] should be differentiated from other [[cardiac]] causes of [[cyanosis]] and [[lung]] olygemia include:
-==Differentiating Tricuspid atresia from other Diseases==
-Patients with tricuspid atresia should be differentiated from other cardiac and non-cardiac causes of cyanosis-
-Cardiac causes (starts with 't'):
 * [[Tetralogy of Fallot]]
-* [[Truncus arteriosus]]
 * [[Total anomalous pulmonary venous connection]]
-* Other tricuspid valve abnormalities like [[tricuspid regurgitaton]], [[tricuspid stenosis]]
+* [[Pulmonary atresia]],
+* [[Tricuspid stenosis]]
+Table below compares [[Congenital heart disease cyanotic|cyanotic heart]] diseases:<ref name="pmid19144126">{{cite journal |vauthors=Bailliard F, Anderson RH |title=Tetralogy of Fallot |journal=Orphanet J Rare Dis |volume=4 |issue= |pages=2 |date=January 2009 |pmid=19144126 |pmc=2651859 |doi=10.1186/1750-1172-4-2 |url=}}</ref><ref name="pmid30065477">{{cite journal |vauthors=Kao CC, Hsieh CC, Cheng PJ, Chiang CH, Huang SY |title=Total Anomalous Pulmonary Venous Connection: From Embryology to a Prenatal Ultrasound Diagnostic Update |journal=J Med Ultrasound |volume=25 |issue=3 |pages=130–137 |date=2017 |pmid=30065477 |pmc=6029298 |doi=10.1016/j.jmu.2017.08.002 |url=}}</ref><ref name="pmid13059216">{{cite journal |vauthors=ASTLEY R, OLDHAM JS, PARSONS C |title=Congenital tricuspid atresia |journal=Br Heart J |volume=15 |issue=3 |pages=287–97 |date=July 1953 |pmid=13059216 |pmc=479498 |doi=10.1136/hrt.15.3.287 |url=}}</ref><ref name="pmid24400257">{{cite journal |vauthors=Unolt M, Putotto C, Silvestri LM, Marino D, Scarabotti A, Valerio Massaccesi, Caiaro A, Versacci P, Marino B |title=Transposition of great arteries: new insights into the pathogenesis |journal=Front Pediatr |volume=1 |issue= |pages=11 |date=June 2013 |pmid=24400257 |pmc=3860888 |doi=10.3389/fped.2013.00011 |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 Findings
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography Findings
+! align="center" style="background:#4479BA; color: #FFFFFF;" + |X-Ray Findings
+|-
+! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tetralogy of Fallot]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
+* [[Polymorphism (biology)|Genetic polymorphisms]]
+* Maternal [[rubella]]
+* Poor prenatal nutrition
+* Maternal [[alcohol]] use
+* Maternal [[diabetes]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Cyanosis]] on exertion
+* [[Exertional dyspnea]]
+* [[Palpitation|Palpitations]]
+* [[Fatigue]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* CBC: [[Anemia]] or [[polycythemia]].
+* [[Coagulation]] profile.
+* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Right ventricular hypertrophy]]
+*[[Right bundle branch block]]
+*[[Tachycardia]]
+* Rate of [[QRS complex|QRS]] change predicts [[Ventricular arrhythmias|ventricular arrhythmia]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+[[Echocardiography]] may show:
+* Residual [[Ventricular septal defect|VSD]] or [[Atrial septal defect|ASD]]
+* RV outflow tract obstruction
+* Abnormal valvular anatomy
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* The '''boot-shaped''' [[heart]] appearance
+* Normal [[heart]] size
+* [[Pulmonary]] vascular marking may be normal or decreased
+|-
+! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Total anomalous pulmonary venous connection|Total Anomalous Pulmonary Venous Connection]]'''
-Other less common causes are- [[pulmonary atresia]], [[hypoplastic left heart syndrome]], [[anomalous systemic venous connection]].
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
+*[[Polymorphism (biology)|Genetic polymorphisms]]
+* Maternal [[rubella]]
+* Poor prenatal nutrition
+* Maternal [[alcohol]] use
+* Maternal [[diabetes]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Tachypnea]]
+* [[Palpitation|Palpitations]]
+* [[Cyanosis]]
+* [[Failure to thrive]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
+* [[Coagulation]] profile.
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Right ventricular hypertrophy]] with a qR pattern
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Right ventricular hypertrophy]]
+*Right ventricular loading
+*Paradoxical septal motion
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Prominence of the [[pulmonary]] arteries
+* Mild enlargement of [[heart]]
+* The classic '''snowman''' sign is seen in supracardiac subtype
+|-
+! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tricuspid atresia|Tricuspid Atresia]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
-Non-cardiac causes:
+*[[Polymorphism (biology)|Genetic polymorphisms]]
-* Pulmonary diseases - Structural abnormalities of the lung, V/P (ventilation-perfusion mismatch), airway obstruction, pneumothorax, and hypoventilation.
+* Maternal [[rubella]]
-* Abnormal hemoglobin like methemoglobin, polycythemia
+* Poor prenatal nutrition
-* Peripheral cyanosis for e.g. sepsis, hypoglycemia, dehydration, and hypoadrenalism.
+* Maternal [[alcohol]] use
+* Maternal [[diabetes]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Respiratory difficulties  as nasal flaring or muscle retractions
+* [[Cyanosis]]
+* Growth retradation
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Arterial blood gas|Arterial blood gases]]
+* [[Complete blood count|CBC]]: [[Polycythemia]]
+* [[Coagulation]] profile
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Tall [[P wave|P waves]] indicate atrial enlargement.
+* First-degree [[atrioventricular block]].
+* Frontal plane [[QRS complex|QRS]] axis may be leftward.
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Echocardiography may show
+* Defect size
+* Pulmonary [[blood flow]]
+*[[Ventricular function]]
+* Valve abnormalities
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Smooth convexity of right [[heart]] border is absent
+* Lower part of right [[heart]] border is limited to the [[spine]]
+* Prominency of the [[pulmonary artery]] depends on their [[blood]] flow
+* [[Cardiac]] size may be normal or enlarged
+|-
+! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Transposition of the great vessels|Transposition of the Great Arteries]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+Multifactorial
+*[[Polymorphism (biology)|Genetic polymorphisms]]
+* Poor prenatal nutrition
+* Maternal [[alcohol]] use
+* Maternal [[diabetes]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* Prominent [[cyanosis]] within hours of birth
+*[[Congestive heart failure]]
+*
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Arterial blood gas|Arterial blood gases]]: [[Hypoxemia]]
+* Hyperoxia test
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* [[Right ventricular hypertrophy]]
+* [[Right axis deviation]]
+* Varying degrees of [[Atrioventricular block|AV block]]
+* [[Q waves]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+[[Echocardiography]] may show:
+* Relationship between [[great vessels]]
+* Associated anatomic lesions
+* [[Coronary artery]] origin and branches
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+* The classic '''egg on string''' appearance
+* [[Pulmonary]] vascular marking may be normal or increased
+|}
 ==References==
 {{reflist|2}}
 [[Category:Cardiovascular system]]
 [[Category:Cardiology]]
 [[Category:Congenital heart disease]]
 [[Category:Pediatrics]]
+[[category:Disease]]
+[[Category:Cardiovascular diseases]]
+[[Category:Up-To-Date cardiology]]
+[[Category:Up-To-Date]]
+[[Category:Needs overview]]
 {{WH}}
 {{WS}}
-'''Bold text'''
+<references />

Tricuspid atresia differential diagnosis: Difference between revisions

Latest revision as of 15:52, 8 November 2020

Overview

Differentiating tricuspid atresia from other Diseases

References

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