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

• • Patients withpulmonary stenosis and closed PAD usually appear cyanotic after birth.
• Physical examination may be remarkable for:
• 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:
• Tachypnea
• poor feeding
• poor growth

Diagnostic Criteria

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

• ASD or PFO

• Small right ventricle

• Left atrium dilation

• Left ventricle dilation

Symptoms

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Symptoms of tricuspid atresia in neonates may include the following:

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• 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:

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

== Physical Examination ==

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• 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

• Digital clubbing
• Cyanosis
• Peripheral edema