Pulmonary atresia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical Examination

Pulmonary Atresia With Intact Ventricular Septum:

Heart

Palpation

Auscultation

Heart Sounds
  • First and second heart sound (S1, S2) are single
Murmurs
  • A holosystolic murmur indicating tricuspid regurgitation best heard at the left lower sternal border may be present
  • In severe tricuspid regurgitation, a diastolic rumble may be present
  • A systolic ejection murmur best heard at the left second or third intercostal space indicating the patent ductus arteriosus may be present.

Pulmonary Atresia With Ventricular Septum defect

Heart

  • Central cyanosis is present
  • "A wave" is prominent in a JVP

Palpation

  • PMI is most prominent at the left lower sternal border

Auscultation

Heart Sounds
  • First heart sound (S1) is normal
  • Second heart sound (S2) is loud and single
Murmurs
  • Systolic murmur best heard at the lower left sternal border is present
  • In presence of patent ductus arteriosus a continuous murmur may be present
  • In presence of aortic regurgitation, an early diastolic murmur is present

References