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{{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==
==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:<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.


==Physical Examination==
Patients with high [[pulmonary blood flow]] without [[stenotic pulmonary arteries]] and with VSD are not[[ cyanotic]] at birth.
===Appearance of the Patient===
[[Physical examination]] may be remarkable for signs of overt [[heart failure ]] include:
Tricuspid atresia is a disease of infants.  The child is growth retarded and appears [[cyanosis|cyanotic]]. The cyanosis is progressive.
*[[Tachypnea]]
*[[poor feeding]]
*[[poor growth]]


===Vitals===
== Diagnostic Criteria ==
====Pulse====
=====Strength=====
The pulse volume may be low.


===Skin===
Bluish discoloration of the skin may be seen.


===Nose===
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>
Nasal flaring may be seen.


===Heart===
* Absent of color flow doppler in[[ tricuspid valve] region
====Inspection====
* The [[apical impulse]] is hyper-dynamic and shifted to the left.


====Palpation====
* [[Atrial septum defect]] (ASD) or [[patent foramen ovale]](PFO)
* A [[thrill]] can be felt on the left parasternal region of the chest.


====Auscultation====
* Small [[ right ventricle]]
* Intensity of [[S1]] may be increased.
* Split [[S2]] may be present.
* A holosystolic crescendo - decrescendo [[murmur]] may be present signifying the flow of blood through a [[ventricular septal defect]].


===Abdomen===
* [[Left atrium ]]dilation
* [[Liver]] is enlarged and pulsations may be felt in the right upper quadrant of the abdomen.


===Extremities===
* [[Left ventricle]] dilation
* Digital [[clubbing]] may be seen.
* [[Cyanosis]] may be seen.


==References==
==References==
{{reflist|2}}
{{reflist|2}}
 
[[Category:Cardiovascular diseases]]
[[Category:Cardiovascular system]]
[[Category:Cardiovascular system]]
[[Category:Cardiology]]
[[Category:Cardiology]]
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[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs overview]]
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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]


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

References

  1. 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.
  2. 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.

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