Transposition of the great vessels history and symptoms
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Transposition of the great vessels Microchapters |
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Classification |
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Differentiating Transposition of the great vessels from other Diseases |
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Treatment |
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Surgery |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Kristin Feeney, B.S. [5]
Overview
The clinical features of D-TGA are solely dependent on the degree of mixing between the parallel circuits. Most patients present with signs and symptoms during the neonatal period. Symptoms of D-TGA present with cyanosis, tachypnea and murmurs. Patients with L-TGA present with symptoms of heart failure until later in life when the right ventricle can no longer compensate increased after load.
History
- Cyanosis can seen soon after the birth, due to the low oxygen saturation of the blood.
- Screening ultrasounds do not routinely reveal TGA in-utero.
- Peripheral areas such as around the mouth and lips, fingertips, and toes are affected first because they are furthest from the heart, and since the circulated blood is not fully oxygenated to begin with, very little oxygen reaches the peripheral arteries.
Symptoms
- The clinical features of D-TGA are solely dependent on the degree of mixing between the parallel circuits.[1]
- Most patients present with signs and symptoms during the neonatal period (first 30 days of life).
The following are the typical clinical manifestations of TGA:
- Cyanosis
- Tachypnea
- Patients usually have a respiratory rate higher than 60 breaths per minute but without retractions, grunting, or flaring and appear comfortable.
- Murmurs
- Murmurs are not typically present unless a small VSD or pulmonic stenosis exists.[3]
- A murmur resulting from a VSD will be pansystolic and prominent at the lower left sternal border.
- Pulmonic stenosis causes a systolic ejection murmur at the upper left sternal border.
- Patients with L-TGA are typically unaffected until later in life when the right ventricle can no longer compensate for the increased afterload of the systemic circulation. These patients present with signs and symptoms of heart failure.
- Other non-specific symptoms include:
| TGA manifestations depending upon intercirculatory mixing and the associated anatomic lesions | |
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| Transposition of the great arteries with intact ventricular septum |
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| Transposition of the great arteries with large ventricular septal defect |
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| Transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction |
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| Transposition of the great arteries with ventricular septal defect and pulmonary vascular obstructive disease |
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References
- ↑ Warnes CA (December 2006). "Transposition of the great arteries". Circulation. 114 (24): 2699–709. doi:10.1161/CIRCULATIONAHA.105.592352. PMID 17159076.
- ↑ Oster ME, Aucott SW, Glidewell J, Hackell J, Kochilas L, Martin GR, Phillippi J, Pinto NM, Saarinen A, Sontag M, Kemper AR (May 2016). "Lessons Learned From Newborn Screening for Critical Congenital Heart Defects". Pediatrics. 137 (5). doi:10.1542/peds.2015-4573. PMC 5227333. PMID 27244826.
- ↑ Van Praagh R, Geva T, Kreutzer J (November 1989). "Ventricular septal defects: how shall we describe, name and classify them?". J. Am. Coll. Cardiol. 14 (5): 1298–9. doi:10.1016/0735-1097(89)90431-2. PMID 2808986.