Tricuspid atresia
cyanotic heart diseases
cardiac causes of cyanosis:
atresia
pulmonary
An 8-yr-old boy is brought to your office because of a heart murmur and dusky blue skin. He has marked clubbing of the fingers and toes, and his h
4/6 ejection systolic murmur in the 2nd left intercostal space . His chest film reveals a decreased pulmonary blood flow as well as a right-sided aort
Tetralogy of Fallot
1. Teratology
' " "" "
' ' of fallot
5-7% CHD
– RV outflow obstruction (RV infundibulum, PS)
– VSD
– Dextroposition of aorta w/ septal override
– RVH
, ● Dyspnea on exertion & tendency to SQUAT
÷
:÷÷÷→
● Paroxysmal hyper cyanotic attack
● growth & developmental delay
Hypoxic, blue or tea spells:
–
-
Common in 1st 2 years.
- -
–
- - -
Hyperpneic, restless, cyanosis increase, gasping respiration & syncope may result.
– Occurs in the morning after initial awakening or after a vigorous crying .
-
– Lasts from few min. to few hrs., rarely fatal
f-
– Disappearance or decrease in the intensity of murmur
– Mild attacks —> weakness & sleep .
– Sever attacks —> unconsciousness , convulsion ,hemi paresis .
– Prolonged attacks —> sever systemic hypoxia & metabolic acidosis .
-1hr ' "
Examination: Systolic murmur , Syser
● The pulse , venous & arterial pressure —> normal. ✓
left
pnecordralbolgetsubszerel imp
● L precordial bulge with sub sternal impulse —> RVH
-
-
● Systolic thrill along L sternal border in 3rd &4th para sternal space .
- -
-
● S2 either single or pulmonic component is soft.
● Systolic murmur : ejection in type at the upper sternal border , holo systolic at the lower sternal border .
● Continuous murmur in presence of collaterals .
-
Ix: inVSD
– CXR :
Normal in size , boot shaped .
-
Clear hilar & pulmonary vascularity (oligaemic lung ).
R sided Aortic arch in 20 % of cases .
cyanotic heart diseases
cardiac causes of cyanosis:
atresia
pulmonary
An 8-yr-old boy is brought to your office because of a heart murmur and dusky blue skin. He has marked clubbing of the fingers and toes, and his h
4/6 ejection systolic murmur in the 2nd left intercostal space . His chest film reveals a decreased pulmonary blood flow as well as a right-sided aort
Tetralogy of Fallot
1. Teratology
' " "" "
' ' of fallot
5-7% CHD
– RV outflow obstruction (RV infundibulum, PS)
– VSD
– Dextroposition of aorta w/ septal override
– RVH
, ● Dyspnea on exertion & tendency to SQUAT
÷
:÷÷÷→
● Paroxysmal hyper cyanotic attack
● growth & developmental delay
Hypoxic, blue or tea spells:
–
-
Common in 1st 2 years.
- -
–
- - -
Hyperpneic, restless, cyanosis increase, gasping respiration & syncope may result.
– Occurs in the morning after initial awakening or after a vigorous crying .
-
– Lasts from few min. to few hrs., rarely fatal
f-
– Disappearance or decrease in the intensity of murmur
– Mild attacks —> weakness & sleep .
– Sever attacks —> unconsciousness , convulsion ,hemi paresis .
– Prolonged attacks —> sever systemic hypoxia & metabolic acidosis .
-1hr ' "
Examination: Systolic murmur , Syser
● The pulse , venous & arterial pressure —> normal. ✓
left
pnecordralbolgetsubszerel imp
● L precordial bulge with sub sternal impulse —> RVH
-
-
● Systolic thrill along L sternal border in 3rd &4th para sternal space .
- -
-
● S2 either single or pulmonic component is soft.
● Systolic murmur : ejection in type at the upper sternal border , holo systolic at the lower sternal border .
● Continuous murmur in presence of collaterals .
-
Ix: inVSD
– CXR :
Normal in size , boot shaped .
-
Clear hilar & pulmonary vascularity (oligaemic lung ).
R sided Aortic arch in 20 % of cases .
