Tricuspid atresia physical examination
|
Tricuspid atresia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Special Scenarios |
|
Case Studies |
|
Tricuspid atresia physical examination On the Web |
|
American Roentgen Ray Society Images of Tricuspid atresia physical examination |
|
Risk calculators and risk factors for Tricuspid atresia physical examination |
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 heart beat 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 stenosis in the pulmonary artery 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 Laboratory Findings In cyanotic older patients laboratory finding may include:
Polycythemia due to secondary erythrocytosis and Elevated prothrombin time and partial thromboplastin time Decreased levels of factors 5,7,8,9: qualitative and quantitative Platelet disorder Increased fibrinolysis and paradoxical thrombotic tendency Proteinuria Hyperuricemia Renal failure Uric acid nephrolithiasis
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.