Tricuspid atresia physical examination: Difference between revisions
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*Left ventricle dilation | *Left ventricle dilation | ||
Symptoms | |||
== Symptoms == | |||
---- | ---- | ||
Symptoms of tricuspid atresia in neonates may include the following: | 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 | *Central cyanosis in mucous membranes and tongue | ||
Rapid breathing | *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: | Symptoms of longstanding cyanosis and hyperviscosity syndrome as a result of secondary erythrocytosis in older children include the following: | ||
Headache | |||
Alter mentation | ---- | ||
Faintness | |||
Dizziness | *Headache | ||
Visual disturbances | *Alter mentation | ||
Paresthesia | *Faintness | ||
Tinnitus | *Dizziness | ||
Myalgia | *Visual disturbances | ||
*Paresthesia | |||
*Tinnitus | |||
*Myalgia | |||
Physical Examination | 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 | |||
Revision as of 14:50, 21 August 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Keri Shafer, M.D. [2] Priyamvada Singh, MBBS[3] Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Physical Examination
Diagnosis
Diagnostic Criteria
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
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
Common physical examination findings associated with fibroadenoma include:[1]
Appearance of the Patient
Tricuspid atresia is a disease of infants. The child is growth retarded and appears cyanotic. The cyanosis is progressive.
Vital Signs
Skin
Bluish discoloration of the skin may be seen.
HEENT
Nasal flaring may be seen.
Neck
- Prominent pulsation of the neck veins
Heart
- The apical impulse is hyper-dynamic and shifted to the left.
- A thrill can be felt on the left parasternal region of the chest.
- Intensity of S1 may be increased.
- Split S2 may be present.
- A holosystolic crescendo - decrescendo murmur may be present signifying the flow of blood through a ventricular septal defect.
- Rough, systolic murmur best heard in the third intercostal space close to the sternum.
Abdomen
- Liver is enlarged and pulsations may be felt in the right upper quadrant of the abdomen.
- Splenic enlargement
Extremities
References
- ↑ ASTLEY R, OLDHAM JS, PARSONS C (1953). "Congenital tricuspid atresia". Br Heart J. 15 (3): 287–97. doi:10.1136/hrt.15.3.287. PMC 479498. PMID 13059216.