Tricuspid atresia - Revision history

Danbot: Add MedicationDose entry for PGE1

2026-03-20T21:21:28Z

Add MedicationDose entry for PGE1

@@ Line 53: / Line 53: @@
 ==Disposition==
 *Admit
 ==See Also==

Rossdonaldson1 at 17:37, 6 November 2024

2024-11-06T17:37:33Z

← Older revision		Revision as of 17:37, 6 November 2024
Line 1:		Line 1:
	==Background==		==Background==
	[[File:Tricuspid atresia.svg\|thumb]]		[[File:Tricuspid atresia.svg\|thumb\|Anterior view of heart with tricuspid atresia with ASD+VSD. White arrows indicate blood flow. Atresic tricuspid valve labeled at bottom left.]]
	*A cyanotic congenital heart defect		*A cyanotic congenital heart defect
	*Absence of tricuspid valve resulting in absence of communication between the right atrium and right ventricle		*Absence of tricuspid valve resulting in absence of communication between the right atrium and right ventricle

ClaireLewis at 18:39, 26 September 2019

2019-09-26T18:39:13Z

← Older revision		Revision as of 18:39, 26 September 2019
Line 21:		Line 21:
	*50% present on the first day of life, additional 30% present by 1 month of age		*50% present on the first day of life, additional 30% present by 1 month of age
	*Central cyanosis is the most notable feature on physical exam and can be progressive		*Central cyanosis is the most notable feature on physical exam and can be progressive
	*May also present with poor feeding		*May also present with [[failure to thrive (peds)\|poor feeding]]
	*Holosystolic murmur at left lower sternal border if VSD is present		*Holosystolic [[murmur]] at left lower sternal border if VSD is present
	*Continuous murmur if there is a PDA		*Continuous murmur if there is a [[PDA
	*Jugular venous distention and prominent “a” wave and hepatomegaly if there is a restrictive atrial level communication		*Jugular venous distention and prominent “a” wave and hepatomegaly if there is a restrictive atrial level communication
	*Tachypnea may be present in patients with unrestrictive pulmonary blood flow		*[[Shortness of breath (peds)\|Tachypnea]] may be present in patients with unrestrictive pulmonary blood flow
	*EKG may show left axis deviation and LVH		*[[EKG]] may show [[left axis deviation]] and [[LVH]]
	*Heart size is normal ~~or mildly~~		*Heart size is normal typically

	==Differential Diagnosis==		==Differential Diagnosis==
Line 33:		Line 33:

	==Evaluation==		==Evaluation==
	*Echocardiography		*[[Echocardiography]]
	*[[Chest x-ray]]		*[[Chest x-ray]]
	**May have a paucity of pulmonary markings and normal heart size in patients with normal pulmonary blood flow (no VSD)		**May have a paucity of pulmonary markings and normal heart size in patients with normal pulmonary blood flow (no VSD)
	**May have cardiomegaly and prominence of pulmonary vascularity in patients with increased pulmonary blood flow (large VSD)		**May have cardiomegaly and prominence of pulmonary vascularity in patients with increased pulmonary blood flow (large VSD)
	*[[ECG]]		*[[ECG]]
	**May demonstrate tall P waves, left axis deviation, LVH, and diminished RV forces		**May demonstrate tall P waves, [[left axis deviation]], [[LVH]], and diminished RV forces

	==Management==		==Management==
	*Stabilize cardiopulmonary function prior to surgery		*Stabilize cardiopulmonary function prior to surgery
	*Supplemental oxygen		*Supplemental [[oxygen]]
	*Mechanical ventilation		*Mechanical ventilation
	*Inotropic agents (eg, [[dopamine]] and [[dobutamine]]) improve myocardial contractility		*Inotropic agents (eg, [[dopamine]] and [[dobutamine]]) improve myocardial contractility

SLuckettG: /* Clinical Features */

2019-02-24T14:27:39Z

Clinical Features

← Older revision		Revision as of 14:27, 24 February 2019
Line 20:		Line 20:
	==Clinical Features==		==Clinical Features==
	*50% present on the first day of life, additional 30% present by 1 month of age		*50% present on the first day of life, additional 30% present by 1 month of age
	*Central cyanosis is the most notable feature on physical exam		*Central cyanosis is the most notable feature on physical exam and can be progressive
	*Holosystolic murmur at left lower sternal border if a VSD is present		*May also present with poor feeding
			*Holosystolic murmur at left lower sternal border if VSD is present
	*Continuous murmur if there is a PDA		*Continuous murmur if there is a PDA
	*Jugular venous distention and prominent “a” wave and hepatomegaly if there is a restrictive atrial level communication		*Jugular venous distention and prominent “a” wave and hepatomegaly if there is a restrictive atrial level communication
	*Tachypnea may be present in patients with unrestrictive pulmonary blood flow		*Tachypnea may be present in patients with unrestrictive pulmonary blood flow
			*EKG may show left axis deviation and LVH
			*Heart size is normal or mildly

	==Differential Diagnosis==		==Differential Diagnosis==

SLuckettG: /* Background */

2019-02-24T14:25:43Z

Background

← Older revision		Revision as of 14:25, 24 February 2019
Line 2:		Line 2:
	[[File:Tricuspid atresia.svg\|thumb]]		[[File:Tricuspid atresia.svg\|thumb]]
	*A cyanotic congenital heart defect		*A cyanotic congenital heart defect
	*Absence of tricuspid valve resulting in ~~abscess~~ of communication between the RA and RV		*Absence of tricuspid valve resulting in absence of communication between the right atrium and right ventricle
			*Due to absence of communication with the right ventricle, RV becomes either under-developed or entirely absent
	*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>		*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>

Line 13:		Line 14:

	===Physiology===		===Physiology===
	*Blood from the RA must exit through the ASD (~~there’s~~ no tricuspid valve)		*Blood from the RA must exit through the ASD (no tricuspid valve)
	*Right to left atrial shunting allows deoxygenated systemic venous blood to enter the LA, then LV		*Right to left atrial shunting allows deoxygenated systemic venous blood to enter the LA, then LV
	*Cyanosis is present ~~given~~ mixing of systemic and pulmonary venous blood in the LA		*Cyanosis is present due to mixing of systemic and pulmonary venous blood in the LA

	==Clinical Features==		==Clinical Features==

Mholtz: Text replacement - "* " to "*"

2017-07-24T01:13:09Z

Text replacement - "* " to "*"

← Older revision		Revision as of 01:13, 24 July 2017
Line 1:		Line 1:
	==Background==		==Background==
	[[File:Tricuspid atresia.svg\|thumb]]		[[File:Tricuspid atresia.svg\|thumb]]
	* A cyanotic congenital heart defect		*A cyanotic congenital heart defect
	*Absence of tricuspid valve resulting in abscess of communication between the RA and RV		*Absence of tricuspid valve resulting in abscess of communication between the RA and RV
	*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>		*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>

Rossdonaldson1 at 17:33, 27 June 2017

2017-06-27T17:33:42Z

← Older revision		Revision as of 17:33, 27 June 2017
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Tricuspid atresia.svg\|thumb]]
	* A cyanotic congenital heart defect		* A cyanotic congenital heart defect
	*Absence of tricuspid valve resulting in abscess of communication between the RA and RV		*Absence of tricuspid valve resulting in abscess of communication between the RA and RV
	*Associated cardiac lesions
	**[[ASD]] (100%)
	**Right ventricular hypoplasia (100%)
	**[[VSD]] (95%)
	**Pulmonary outflow obstruction (75%)
	**[[Transposition of the great arteries]] (28%)
	*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>		*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>

	[[~~File:Tricuspid atresia.svg\|thumb~~]]		===Associated cardiac lesions===
			*[[ASD]] (100%)
			*Right ventricular hypoplasia (100%)
			*[[VSD]] (95%)
			*Pulmonary outflow obstruction (75%)
			*[[Transposition of the great arteries]] (28%)

	===Physiology===		===Physiology===

Mholtz at 01:09, 27 June 2017

2017-06-27T01:09:30Z

← Older revision		Revision as of 01:09, 27 June 2017
Line 1:		Line 1:
	~~[[File:Tricuspid atresia.svg\|thumb]]~~
	==Background==		==Background==
	* A cyanotic congenital heart defect		* A cyanotic congenital heart defect
Line 10:		Line 9:
	**[[Transposition of the great arteries]] (28%)		**[[Transposition of the great arteries]] (28%)
	*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>		*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>

			[[File:Tricuspid atresia.svg\|thumb]]

	===Physiology===		===Physiology===
Line 15:		Line 16:
	*Right to left atrial shunting allows deoxygenated systemic venous blood to enter the LA, then LV		*Right to left atrial shunting allows deoxygenated systemic venous blood to enter the LA, then LV
	*Cyanosis is present given mixing of systemic and pulmonary venous blood in the LA		*Cyanosis is present given mixing of systemic and pulmonary venous blood in the LA

	==Clinical Features==		==Clinical Features==
	*50% present on the first day of life, additional 30% present by 1 month of age		*50% present on the first day of life, additional 30% present by 1 month of age
Line 52:		Line 54:

	==External Links==		==External Links==


	==References==		==References==

Lisayee25: Created page with "thumb ==Background== * A cyanotic congenital heart defect *Absence of tricuspid valve resulting in abscess of communication between the RA and R..."

2017-06-25T18:27:54Z

Created page with "thumb ==Background== * A cyanotic congenital heart defect *Absence of tricuspid valve resulting in abscess of communication between the RA and R..."

New page

[[File:Tricuspid atresia.svg|thumb]]
==Background==
* A cyanotic congenital heart defect
*Absence of tricuspid valve resulting in abscess of communication between the RA and RV
*Associated cardiac lesions
**[[ASD]] (100%)
**Right ventricular hypoplasia (100%)
**[[VSD]] (95%)
**Pulmonary outflow obstruction (75%)
**[[Transposition of the great arteries]] (28%)
*Third most common cyanotic [[congenital heart disease]] <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>

===Physiology===
*Blood from the RA must exit through the ASD (there’s no tricuspid valve)
*Right to left atrial shunting allows deoxygenated systemic venous blood to enter the LA, then LV
*Cyanosis is present given mixing of systemic and pulmonary venous blood in the LA
==Clinical Features==
*50% present on the first day of life, additional 30% present by 1 month of age
*Central cyanosis is the most notable feature on physical exam
*Holosystolic murmur at left lower sternal border if a VSD is present
*Continuous murmur if there is a PDA
*Jugular venous distention and prominent “a” wave and hepatomegaly if there is a restrictive atrial level communication
*Tachypnea may be present in patients with unrestrictive pulmonary blood flow

==Differential Diagnosis==
{{Congenital heart disease DDX}}

==Evaluation==
*Echocardiography
*[[Chest x-ray]]
**May have a paucity of pulmonary markings and normal heart size in patients with normal pulmonary blood flow (no VSD)
**May have cardiomegaly and prominence of pulmonary vascularity in patients with increased pulmonary blood flow (large VSD)
*[[ECG]]
**May demonstrate tall P waves, left axis deviation, LVH, and diminished RV forces

==Management==
*Stabilize cardiopulmonary function prior to surgery
*Supplemental oxygen
*Mechanical ventilation
*Inotropic agents (eg, [[dopamine]] and [[dobutamine]]) improve myocardial contractility
*[[Prostaglandin E1]]
**Maintain adequate ductal dependent pulmonary flow
**Start infusion at 0.05 mcg/kg/min IV and titrate up to 0.1 mcg/kg/min, monitoring for hypotension and apnea
**Side Effects: Hypotension, Bradycardia, Seizures and Apnea
*Staged surgical repair

==Disposition==
*Admit

==See Also==
*[[Congenital heart disease]]

==External Links==

==References==
<references/>

[[Category:Cardiology]]
[[Category:Pediatrics]]