Pulmonary atresia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

Pulmonary Atresia With Intact Ventricular Septum:

• Central cyanosis is present

Heart

Palpation

• Left ventricular impulse is prominent at cardiac apex
• Thrill may be present in case of severe tricuspid regurugitation

Auscultation

Heart Sounds

• First and second heart sound (S1,S2) are single

Murmurs

• A pansystolic murmur may be present indicating tricuspid regurgitation
• Best heard at the left lower sternal border
• In severe tricuspid regurgitation, a diastolic rumble may be present
• A systolic ejection murmur best heard at the left second or third intercostal space indicating the patent ductus arteriosus may be present.

Heart

• Central cyanosis is present
• "A wave" is prominent in a JVP

Palpation

• PMI is most prominent at the left lower sternal border

Auscultation

Heart Sounds

• First heart sound (S1) is normal
• Second heart sound (S2) is loud and single

Murmurs

• Systolic murmur best heard at the lower left sternal border is present
• In presence of patent ductus arteriosus a continuous murmur may be present
• In presence of aortic regurgitation, an early diastolic murmur is present