Tricuspid atresia physical examination

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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]

Physical Examination

Diagnostic Criteria

The diagnosis of tricuspid atresia is made when at least of the following three diagnostic criteria are met inechocardiography: Absent of color flow doppler in tricuspid valve region

Symptoms


Symptoms of tricuspid atresia in neonates may include the following:


  • Central cyanosis in mucous membranes and tongue
  • Poor feeding and growth retardation
  • Difficulty in breathing
  • Rapid heartbeat
  • Rapid breathing

Symptoms of longstanding cyanosis and hyperviscosity syndrome as a result of secondary erythrocytosis in older children include the following:


  • Headache
  • Alter mentation
  • Faintness
  • Dizziness
  • Visual disturbances
  • Paresthesia
  • Tinnitus
  • Myalgia


== Physical Examination ==



  • Patients with pulmonary stenosis and closed PAD usually appear cyanotic after birth.
  • Physical examination may be remarkable for:
    • Normal pulses
    • Diminished right ventricle impulse
    • Thrill due to VSD or severe PS
    • Holosystolic murmured in LSB due to VSD
    • The continuous murmur of 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 symptoms and signs of overt heart failure:
    • Tachypnea
    • poor feeding
    • poor growth











Abdomen

  • Liver is enlarged and pulsations may be felt in the right upper quadrant of the abdomen.
  • Splenic enlargement

Extremities

References

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