Pulmonic regurgitation differential diagnosis: Difference between revisions

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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Pulmonary Valve Regurgitation]]'''
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*PR is best heard over the left second and third interspaces and increases with inspiration
*Usually secondary to repair of tetralogy of Fallot or pulmonic Valve stenosis.
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Aortic Regurgitation]]'''
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==Other differential diagnosis==
==Other differential diagnosis==
* [[Pulmonary hypertension]]
* [[Pulmonary hypertension]]

Revision as of 15:05, 3 January 2017

Pulmonic regurgitation Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential diagnosis

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X-Ray

Echocardiography

Cardiac MRI

Severity Assessment

Treatment

Medical Therapy

Surgical therapy

Follow up

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2], Aysha Anwar, M.B.B.S[3]

Overview

Differential diagnosis of pulmonic regurgitation

The diseases which may present with overlapping symptoms as pulmonic regurgitation may include the following:

Disease Findings
Aortic Regurgitation
  • Patients present with dyspnea and fatigability as a consequence of reduced cardiac reserve in the fourth or fifth decade[1]
  • AR is heard over left sternal border or over the right second interspace and radiates to the neck
Tricuspid Regurgitation causing RV enlargement
  • Pansystolic murmur accentuating with inspiration[2]
  • RV heave
  • Gaint "V" wave seen on JVP examination
  • Hepatomegaly is seen in 90% of patients
  • Quantification of severity of TR is done by colour flow doppler imaging[3]
Left to Right Shunt causing RV enlargement
  • Usually seen in children with acyanotic congenital disease such as ASD
  • Fixed splitting of S2 is present
Arrthmogenic Right Ventricular Cardiomyopathy
  • Gradual replacement of normal functional myocardium with adipose or fibroadipose tissue[4]
  • Age of onset is 7 to 40years
  • Patients are usually asymptomatic, present with occasional palpitations
  • EKG shows negative "T" waves and epsilon waves with selective "S" wave delay in V1 to V3
  • RV is dilated and hypokinetic on echocardiography
  • Holter is the diagnostic test to diagnose hyperkinetic ventricular arrythmias

Other differential diagnosis

References

  1. Template:Citejournal
  2. Sepulveda, G.; Lukas, D. S. (1955). "The Diagnosis of Tricuspid Insufficiency: Clinical Features in 60 Cases with Associated Mitral Valve Disease". Circulation. 11 (4): 552–563. doi:10.1161/01.CIR.11.4.552. ISSN 0009-7322.
  3. Zoghbi, W (2003). "Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiography". Journal of the American Society of Echocardiography. 16 (7): 777–802. doi:10.1016/S0894-7317(03)00335-3. ISSN 0894-7317.
  4. Graziosi M, Rapezzi C (2016). "Right ventricular arrhythmogenic cardiomyopathy: genetic and MR for modern clinical diagnosis". J Cardiovasc Med (Hagerstown). doi:10.2459/JCM.0000000000000470. PMID 27828830.

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