Total anomalous pulmonary venous connection physical examination: Difference between revisions

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Latest revision as of 23:55, 14 April 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS [4]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

The physical findings depend on the degree of obstruction and the degree of left-to-right shunting. Physical examination of patients may be remarkable for a decreased pulse, hypotension, tachypnea, peripheral edema, S3 gallop, diastolic murmur due to tricuspid regurgitation, hepatomegaly, and cyanosis.

Physical Examination

The physical examination in patients with total anomalous pulmonary venous connection depends on the following factors:^[1]^[2]

Type of anatomic connection present between systemic and pulmonary venous circulation
Degree of obstruction
Type of obstruction (obstructed, unobstructed)
Amount of right to left shunting

Vitals

Pulse

Decreased pulses (low systemic blood flow)

Blood Pressure

Hypotension (low systemic blood flow)

Respiratory Rate

Tachypnea (right sided volume overload)
Peripheral edema (right sided heart failure)

Heart

Cardiovascular examination of patients with total anomalous pulmonary venous connection may be remarkable for:

Inspection

Precodial asymmetry indicating right ventricular hypertrophy may be present.

Palpation

Right ventricular heave or lift may be present.

Auscultation

Heart Sounds

Prominent, fixed split second heart sound (S2) is present.
S3 gallop may be present.

References

↑ Driscoll, David J. (2016). "Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return": 369–371. doi:10.1007/978-3-7091-1883-2_28.
↑ Pollack, Charles V. (2019). doi:10.1007/978-3-319-63895-9. Missing or empty |title= (help)

Template:WH Template:WS

[Driscoll2016-1] Driscoll, David J. (2016). "Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return": 369–371. doi:10.1007/978-3-7091-1883-2_28.

[Pollack2019-2] Pollack, Charles V. (2019). doi:10.1007/978-3-319-63895-9. Missing or empty |title= (help)

[1]

[2]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Template:Total anomalous pulmonary venous connection}}
-{{CMG}}
+{{CMG}}; {{AE}} {{CZ}}; [[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]
-'''Associate Editors-In-Chief:''' {{CZ}}; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
+==Overview==
+The physical findings depend on the degree of obstruction and the degree of [[Left-to-right shunt|left-to-right shunting]]. [[Physical examination]] of [[patients]] may be remarkable for a decreased [[pulse]], [[hypotension]], [[tachypnea]], peripheral [[edema]], [[S3 gallop]], [[diastolic murmur]] due to tricuspid regurgitation, [[hepatomegaly]], and [[cyanosis]].
-'''Overview'''- The physical finding depends on the degree of obstruction and the degree of left-to-right shunting.
+==Physical Examination==
+The [[physical examination]] in [[patients]] with total anomalous pulmonary venous connection depends on the following factors:<ref name="Driscoll2016">{{cite journal|last1=Driscoll|first1=David J.|title=Clinical Presentation and Therapy of Total Anomalous Pulmonary Venous Return|year=2016|pages=369–371|doi=10.1007/978-3-7091-1883-2_28}}</ref><ref name="Pollack2019">{{cite journal|last1=Pollack|first1=Charles V.|year=2019|doi=10.1007/978-3-319-63895-9}}</ref>
-The '''physical examination''' in patients with total anomalous pulmonary venous connection '''depends''' on the following factors-
 * Type of anatomic connection present between systemic and pulmonary venous circulation
 * Degree of obstruction
 * Type of obstruction (obstructed, unobstructed)
-* Amount of right to left shunting
+* Amount of [[right to left shunting]]
-=='''Physical Examination'''==
-'''General Physical examination'''
-* Cyanosis (right to left shunt)
-* Decreased pulses (low systemic blood flow)
-* Hypotension (low systemic blood flow)
-* Tachypnea (right sided volume overload)
-* Hepatomegaly, peripheral edema (right sided heart failure)
-'''Cardiovascular examination'''
-'''Inspection'''
-* Precodial asymmetry indicating right ventricular hypertrophy
-'''Palpation'''
-* Right ventricular [[heave]]
-'''Auscultation'''
-* Prominent, Fixed split second heart sound (S2)
-* [[S3 gallop]]
-* Systolic ejection [[murmur]] at left upper sternal border
-* Diastolic murmur due to tricuspid regurgitation
+===Vitals===
+====Pulse====
+* Decreased [[pulses]] (low systemic blood flow)
+====Blood Pressure====
+* [[Hypotension]] (low systemic blood flow)
+====Respiratory Rate====
+* [[Tachypnea]] (right sided volume overload)
+* Peripheral [[edema]] ([[right heart failure|right sided heart failure]])
+===Heart===
+* [[Cardiovascular]] examination of [[patients]] with total anomalous pulmonary venous connection may be remarkable for:
+====Inspection====
+* Precodial asymmetry indicating right [[ventricular hypertrophy]] may be present.
+====Palpation====
+*[[Right ventricular]] [[heave]] or lift may be present.
+====Auscultation====
+=====Heart Sounds=====
+* Prominent, fixed [[split second heart sound]] (S2) is present.
+* [[S3 gallop]] may be present.
+{{#ev:youtube|f2WYFIT_09Q}}
+=====Murmurs=====
+* [[Systolic ejection murmur]] due to increased [[stroke volume]] across the [[pulmonary valve]] best heard at the [[Left sternal border|left upper sternal border]] may be present. [[Ejection murmurs]] are more prominent in unobstructed [[TAPVC]].
+* [[Diastolic murmur]] due to [[tricuspid regurgitation]] may be present.
+===Abdomen===
+* [[Hepatomegaly]]
+===Extremities===
+* [[Cyanosis]] ([[right to left shunt]])
 ==References==
-{{reflist}}
+{{reflist|2}}
 [[Category:Cardiovascular system]]
 [[Category:Cardiology]]
 [[Category:Congenital heart disease]]
 [[Category:Pediatrics]]
+[[Category:Disease]]
-[[pl:Całkowite nieprawidłowe przyłączenie żył płucnych]]
 {{WH}}
 {{WS}}