Total anomalous pulmonary venous connection physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The physical | The physical findings depend on the degree of obstruction and the degree of left-to-right shunting. | ||
==Physical Examination== | ==Physical Examination== | ||
The physical examination in patients with total anomalous pulmonary venous connection depends on the following factors: | 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 | * Type of anatomic connection present between systemic and pulmonary venous circulation | ||
* Degree of obstruction | * Degree of obstruction | ||
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* Decreased pulses (low systemic blood flow) | * Decreased pulses (low systemic blood flow) | ||
====Blood Pressure==== | ====Blood Pressure==== | ||
* Hypotension (low systemic blood flow) | * [[Hypotension]] (low systemic blood flow) | ||
====Respiratory Rate==== | ====Respiratory Rate==== | ||
* Tachypnea (right sided volume overload) | * [[Tachypnea]] (right sided volume overload) | ||
* Peripheral edema (right sided heart failure) | * Peripheral [[edema]] ([[right heart failure|right sided heart failure]]) | ||
===Heart=== | ===Heart=== | ||
====Inspection==== | ====Inspection==== | ||
* Precodial asymmetry indicating right ventricular hypertrophy may be present | * Precodial asymmetry indicating right [[ventricular hypertrophy]] may be present | ||
====Palpation==== | ====Palpation==== | ||
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====Auscultation==== | ====Auscultation==== | ||
=====Heart Sounds===== | =====Heart Sounds===== | ||
* Prominent, fixed split second heart sound (S2) is present | * Prominent, fixed [[split second heart sound]] (S2) is present | ||
* [[S3 gallop]] may be present | * [[S3 gallop]] may be present | ||
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=====Murmurs===== | =====Murmurs===== | ||
* Systolic ejection | * [[Systolic ejection murmur]] due to increased stroke volume across the pulmonary valve best heard at left upper sternal border may be present. Ejection murmurs are more prominent in unobstructed [[TAPVC]]. | ||
* Diastolic murmur due to tricuspid regurgitation may be present. | * [[Diastolic murmur]] due to tricuspid regurgitation may be present. | ||
===Abdomen=== | ===Abdomen=== | ||
* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
===Extremities=== | ===Extremities=== | ||
Revision as of 21:18, 8 April 2013
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Total anomalous pulmonary venous connection Microchapters |
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Differentiating Total anomalous pulmonary venous connection from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Total anomalous pulmonary venous connection physical examination On the Web |
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American Roentgen Ray Society Images of Total anomalous pulmonary venous connection physical examination |
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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
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
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
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 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
Extremities
- Cyanosis (right to left shunt)