Pulmonary atresia diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
= Diagnostic Study of Choice = | |||
=== Prenatally === | |||
*[[Echocardiography]] is the gold standard test for the diagnosis of Pulmonary atresia pre or post-natally. | |||
*It is recommended to screen every pregnant women during second trimester for the congenital heart disease including pulmonary atresia. | |||
*The classic echocardiographic findings include an atretic pulmonary valve, a hypoplastic tricuspid valve (TV) and right ventricle (RV) <ref name="pmid16882782">{{cite journal| author=Salvin JW, McElhinney DB, Colan SD, Gauvreau K, del Nido PJ, Jenkins KJ | display-authors=etal| title=Fetal tricuspid valve size and growth as predictors of outcome in pulmonary atresia with intact ventricular septum. | journal=Pediatrics | year= 2006 | volume= 118 | issue= 2 | pages= e415-20 | pmid=16882782 | doi=10.1542/peds.2006-0428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16882782 }} </ref> <ref name="pmid18570204">{{cite journal| author=Iacobelli R, Pasquini L, Toscano A, Raimondi F, Michielon G, Tozzi AE | display-authors=etal| title=Role of tricuspid regurgitation in fetal echocardiographic diagnosis of pulmonary atresia with intact ventricular septum. | journal=Ultrasound Obstet Gynecol | year= 2008 | volume= 32 | issue= 1 | pages= 31-5 | pmid=18570204 | doi=10.1002/uog.5356 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18570204 }} </ref> <ref name="pmid17098143">{{cite journal| author=Peterson RE, Levi DS, Williams RJ, Lai WW, Sklansky MS, Drant S| title=Echocardiographic predictors of outcome in fetuses with pulmonary atresia with intact ventricular septum. | journal=J Am Soc Echocardiogr | year= 2006 | volume= 19 | issue= 11 | pages= 1393-400 | pmid=17098143 | doi=10.1016/j.echo.2006.05.021 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17098143 }} </ref> <ref name="pmid18724024">{{cite journal| author=Kawazu Y, Inamura N, Kayatani F| title=Prediction of therapeutic strategy and outcome for antenatally diagnosed pulmonary atresia/stenosis with intact ventricular septum. | journal=Circ J | year= 2008 | volume= 72 | issue= 9 | pages= 1471-5 | pmid=18724024 | doi=10.1253/circj.cj-07-0629 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18724024 }} </ref> <ref name="pmid18371563">{{cite journal| author=Gardiner HM, Belmar C, Tulzer G, Barlow A, Pasquini L, Carvalho JS | display-authors=etal| title=Morphologic and functional predictors of eventual circulation in the fetus with pulmonary atresia or critical pulmonary stenosis with intact septum. | journal=J Am Coll Cardiol | year= 2008 | volume= 51 | issue= 13 | pages= 1299-308 | pmid=18371563 | doi=10.1016/j.jacc.2007.08.073 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18371563 }} </ref>. Other finding that aids in diagnosis includes: | |||
**reversed ductal flow i.e blood flowing from the Aorta to the Pulmonary artery in contrast to normal ductal flow from RV to Aorta | |||
**coronary artery abnormalities are largely dependant on the severity of hypoplasia of the right ventricle are also been identified and helps in deciding the surgical approach. <ref name="pmid15773446">{{cite journal| author=Sandor GG, Cook AC, Sharland GK, Ho SY, Potts JE, Anderson RH| title=Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum diagnosed during fetal life. | journal=Cardiol Young | year= 2002 | volume= 12 | issue= 5 | pages= 436-44 | pmid=15773446 | doi=10.1017/s1047951102000756 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15773446 }} </ref> <ref name="pmid14676255">{{cite journal| author=Emmel M, Bald R, Brockmeier K| title=Pulmonary atresia with intact ventricular septum and right coronary artery to right ventricle fistula detected in utero. | journal=Heart | year= 2004 | volume= 90 | issue= 1 | pages= 94 | pmid=14676255 | doi=10.1136/heart.90.1.94 | pmc=1768034 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14676255 }} </ref> | |||
OR | OR | ||
Latest revision as of 18:54, 18 July 2020
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Pulmonary atresia diagnostic study of choice On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Diagnostic Study of Choice
Prenatally
- Echocardiography is the gold standard test for the diagnosis of Pulmonary atresia pre or post-natally.
- It is recommended to screen every pregnant women during second trimester for the congenital heart disease including pulmonary atresia.
- The classic echocardiographic findings include an atretic pulmonary valve, a hypoplastic tricuspid valve (TV) and right ventricle (RV) [1] [2] [3] [4] [5]. Other finding that aids in diagnosis includes:
- reversed ductal flow i.e blood flowing from the Aorta to the Pulmonary artery in contrast to normal ductal flow from RV to Aorta
- coronary artery abnormalities are largely dependant on the severity of hypoplasia of the right ventricle are also been identified and helps in deciding the surgical approach. [6] [7]
OR
The following result of [gold standard test] is confirmatory of [disease name]:
- [Result 1]
- [Result 2]
OR
[Name of the investigation] must be performed when:
- The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
- A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
OR
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
OR
The diagnostic study of choice for [disease name] is [name of the investigation].
OR
There is no single diagnostic study of choice for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
OR
[Disease name] is primarily diagnosed based on the clinical presentation.
OR
Investigations:
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
- Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
The comparison of various diagnostic studies for [disease name]
| Test | Sensitivity | Specificity |
|---|---|---|
| Test 1 | ...% | ...% |
| Test 2 | ...% | ...% |
[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity
Diagnostic results
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
- [Finding 1]
- [Finding 2]
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
IF there are no established diagnostic criteria
There are no established criteria for the diagnosis of [disease name].
References
- ↑ Salvin JW, McElhinney DB, Colan SD, Gauvreau K, del Nido PJ, Jenkins KJ; et al. (2006). "Fetal tricuspid valve size and growth as predictors of outcome in pulmonary atresia with intact ventricular septum". Pediatrics. 118 (2): e415–20. doi:10.1542/peds.2006-0428. PMID 16882782.
- ↑ Iacobelli R, Pasquini L, Toscano A, Raimondi F, Michielon G, Tozzi AE; et al. (2008). "Role of tricuspid regurgitation in fetal echocardiographic diagnosis of pulmonary atresia with intact ventricular septum". Ultrasound Obstet Gynecol. 32 (1): 31–5. doi:10.1002/uog.5356. PMID 18570204.
- ↑ Peterson RE, Levi DS, Williams RJ, Lai WW, Sklansky MS, Drant S (2006). "Echocardiographic predictors of outcome in fetuses with pulmonary atresia with intact ventricular septum". J Am Soc Echocardiogr. 19 (11): 1393–400. doi:10.1016/j.echo.2006.05.021. PMID 17098143.
- ↑ Kawazu Y, Inamura N, Kayatani F (2008). "Prediction of therapeutic strategy and outcome for antenatally diagnosed pulmonary atresia/stenosis with intact ventricular septum". Circ J. 72 (9): 1471–5. doi:10.1253/circj.cj-07-0629. PMID 18724024.
- ↑ Gardiner HM, Belmar C, Tulzer G, Barlow A, Pasquini L, Carvalho JS; et al. (2008). "Morphologic and functional predictors of eventual circulation in the fetus with pulmonary atresia or critical pulmonary stenosis with intact septum". J Am Coll Cardiol. 51 (13): 1299–308. doi:10.1016/j.jacc.2007.08.073. PMID 18371563.
- ↑ Sandor GG, Cook AC, Sharland GK, Ho SY, Potts JE, Anderson RH (2002). "Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum diagnosed during fetal life". Cardiol Young. 12 (5): 436–44. doi:10.1017/s1047951102000756. PMID 15773446.
- ↑ Emmel M, Bald R, Brockmeier K (2004). "Pulmonary atresia with intact ventricular septum and right coronary artery to right ventricle fistula detected in utero". Heart. 90 (1): 94. doi:10.1136/heart.90.1.94. PMC 1768034. PMID 14676255.