Tricuspid atresia physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief:Sara Zand, M.D.[2] Keri Shafer, M.D. [3] Priyamvada Singh, MBBS[4] Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]
Physical Examination
- Patients withpulmonary stenosis and closed PAD usually appear cyanotic after birth.
- Physical examination may be remarkable for:
- Normal pulses
- Diminished right ventricle impulse
- Thrill due to ventricular septum defect (VSD) or severe Pulmonary stenosis(ps)
- Holosystolic murmured in left sternal border due to ventricular septum defect( VSD)
- The continuous murmur of patent ductus arteriosus (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 notcyanotic at birth.
- Physical examination may be remarkable for signs of overt heart failure include:
- Tachypnea
- poor feeding
- poor growth
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
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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
Abdomen
- Liver is enlarged and pulsations may be felt in the right upper quadrant of the abdomen.
- Splenic enlargement