Tricuspid atresia physical examination: Difference between revisions
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{{Template:Tricuspid atresia}} | {{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:psingh13579@gmail.com] '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | {{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 [[ pulmonary stenosis]] and closed PAD usually appear [[cyanotic]] after birth. Conversely, patients with [[VSD]] and high [[pulmonary blood flow]] without [[stenotic pulmonary arteries]] present with signs of overt [[heart failure]] without [[cyanosis]]. | |||
==Physical Examination== | ==Physical Examination== | ||
Patients with [[ pulmonary stenosis]] and closed PAD usually appear [[cyanotic]] after birth. | |||
[[Physical examination]] may be remarkable for:<ref name="pmid19391004">{{cite journal |vauthors=Rao PS |title=Diagnosis and management of cyanotic congenital heart disease: part I |journal=Indian J Pediatr |volume=76 |issue=1 |pages=57–70 |date=January 2009 |pmid=19391004 |doi=10.1007/s12098-009-0030-4 |url=}}</ref> | |||
*[[Normal pulses]] | |||
*Diminished [[right ventricle]] impulse | |||
*[[Thrill]] due to [[ventricular septum defect]] ([[VSD]]) or [[severe Pulmonary stenosis]](ps) | |||
*[[Holosystolic murmured]] in left sternal border due to [[ventricular septum defect]]( VSD) | |||
*The [[continuous murmur]] of [[patent ductus arteriosus]] (PDA), occasionally | |||
*[[Systolic ejection murmur[[ in [[left upper sternal border]] due to PS | |||
*[[clubbing]] in older patients and unrepaired disease. | |||
Patients with high [[pulmonary blood flow]] without [[stenotic pulmonary arteries]] and with VSD are not[[ cyanotic]] at birth. | |||
[[Physical examination]] may be remarkable for signs of overt [[heart failure ]] include: | |||
*[[Tachypnea]] | |||
*[[poor feeding]] | |||
*[[poor growth]] | |||
== Diagnostic Criteria == | |||
The diagnosis of [[tricuspid atresia]] is made when at least of the following three diagnostic criteria are met in [[ echocardiography]]:<ref name="BergLachmann2010">{{cite journal|last1=Berg|first1=C.|last2=Lachmann|first2=R.|last3=Kaiser|first3=C.|last4=Kozlowski|first4=P.|last5=Stressig|first5=R.|last6=Schneider|first6=M.|last7=Asfour|first7=B.|last8=Herberg|first8=U.|last9=Breuer|first9=J.|last10=Gembruch|first10=U.|last11=Geipel|first11=A.|title=Prenatal diagnosis of tricuspid atresia: intrauterine course and outcome|journal=Ultrasound in Obstetrics and Gynecology|volume=35|issue=2|year=2010|pages=183–190|issn=09607692|doi=10.1002/uog.7499}}</ref> | |||
* | * Absent of color flow doppler in[[ tricuspid valve] region | ||
* | * [[Atrial septum defect]] (ASD) or [[patent foramen ovale]](PFO) | ||
* | * Small [[ right ventricle]] | ||
* [[Left atrium ]]dilation | |||
* [[Left ventricle]] dilation | |||
*[[ | |||
==References== | ==References== | ||
Latest revision as of 16:42, 8 November 2020
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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 pulmonary stenosis and closed PAD usually appear cyanotic after birth. Conversely, patients with VSD and high pulmonary blood flow without stenotic pulmonary arteries present with signs of overt heart failure without cyanosis.
Physical Examination
Patients with pulmonary stenosis and closed PAD usually appear cyanotic after birth. Physical examination may be remarkable for:[1]
- Normal pulses
- Diminished right ventricle impulse
- Thrill due to ventricular septum defect (VSD) or severe Pulmonary stenosis(ps)
- Holosystolic murmured in left sternal border due to ventricular septum defect( VSD)
- The continuous murmur of patent ductus arteriosus (PDA), occasionally
- [[Systolic ejection murmur[[ in left upper sternal border due to PS
- clubbing in older patients and unrepaired disease.
Patients with high pulmonary blood flow without stenotic pulmonary arteries and with VSD are notcyanotic at birth.
Physical examination may be remarkable for signs of overt heart failure include:
Diagnostic Criteria
The diagnosis of tricuspid atresia is made when at least of the following three diagnostic criteria are met in echocardiography:[2]
- Absent of color flow doppler in[[ tricuspid valve] region
- Atrial septum defect (ASD) or patent foramen ovale(PFO)
- Small right ventricle
- Left ventricle dilation
References
- ↑ Rao PS (January 2009). "Diagnosis and management of cyanotic congenital heart disease: part I". Indian J Pediatr. 76 (1): 57–70. doi:10.1007/s12098-009-0030-4. PMID 19391004.
- ↑ Berg, C.; Lachmann, R.; Kaiser, C.; Kozlowski, P.; Stressig, R.; Schneider, M.; Asfour, B.; Herberg, U.; Breuer, J.; Gembruch, U.; Geipel, A. (2010). "Prenatal diagnosis of tricuspid atresia: intrauterine course and outcome". Ultrasound in Obstetrics and Gynecology. 35 (2): 183–190. doi:10.1002/uog.7499. ISSN 0960-7692.