Congenital cyanotic heart disease: Difference between revisions
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== Overview == | == Overview == | ||
Congenital cyanotic heart disease is a group of heart defects that will causes neonatal [[cyanosis]]. The [[patient]] appears blue ([[Cyanosis|cyanotic]]), due to [[deoxygenated blood]] bypassing the [[Lung|lungs]] and entering the [[systemic circulation]]. This can be caused by [[Right-to-left shunt|right-to-left]] or [[Bidirectional shunt|bidirectional]] [[Shunt (medical)|shunting]], or malposition of the [[great arteries]]. Such defects include [[persistent truncus arteriosus]], [[total anomalous pulmonary venous connection]], [[tetralogy of Fallot]], [[transposition of the great vessels]], and [[Ebstein's anomaly]]. | |||
== Classification == | == Classification == | ||
Congenital cyanotic heart disease may be classified according to [[Anatomy|anatomical]] [[defect]] into 5 subgroups: | |||
*[[Tetralogy of Fallot|Tetralogy of fallot]] | |||
**It is understood that tetralogy of fallot is the result of improper positioning of the outlet [[septum]]. | |||
**In the normal [[heart]], the outlet septum is an indistinguishable component of the crista supraventricularis that communicates with the [[Septomarginal trabecula|septomarginal trabeculae]] to divide the [[Right ventricle|right]] and [[Left ventricle|left]] [[Ventricle|ventricular cavities]]. | |||
**In Tetralogy of Fallot, proper [[Ventricle (heart)|ventricular]] septation is perturbed by anterocephalad displacement of the outlet [[Septum (disambiguation)|septum]] relative to the [[septomarginal trabecula]]. | |||
**The direct consequence of this misalignment is an [[Overriding aorta|overriding aortic orifice]] and a [[ventricular septal defect]], resulting in an intracardiac [[Right-to-left shunt|right to left shunt]] of blood. | |||
**In addition, anterocephalad displacement of the outlet septum indirectly predisposes the [[pulmonary trunk]] to [[Pulmonary stenosis|stenosis]] in the setting of septoparietal trabecular [[hypertrophy]]. | |||
**Together, the displacement of the outlet [[septum]] coupled with the [[Hypertrophy (medical)|hypertrophic]] arrangement of the septoparietal trabeculae account for the three [[Anatomy|anatomical]] cardinal [[Defect|defects]] in Tetralogy of Fallot - [[Aorta|aortic]] dextroposition, [[Ventricular septal defect|interventricular communication]] ([[VSD]]), and [[pulmonary stenosis]]. | |||
**The fourth [[defect]] - [[right ventricular hypertrophy]] - is a [[hemodynamic]] consequence of these three [[Morphology|morphologic]] changes, as the [[right ventricle]] physiologically adapts to the increased [[resistance]] of a [[Pulmonary stenosis|stenotic pulmonary trunk]]. | |||
*[[Total anomalous pulmonary venous connection (patient information)|Total anomalous pulmonary venous connection]] | |||
**n this condition,the right side of heart is receiving blood both from [[Pulmonary circulation|pulmonary]] and [[systemic circulation]]. | |||
**There is a mixing of oxygenated [[pulmonary]] venous blood with deoxygenated blood from [[systemic circulation]]. | |||
** The mixing of [[blood]] could occur at three levels i.e. supracardiac, infracardiac and cardiac. | |||
**In the former two the mixing occurs outside the [[heart]] and in latter inside the [[heart]] ([[right atrium]]). | |||
*[[Transposition of the great arteries]] | |||
**In the TGA the [[aorta]] arises from the morphologic [[right ventricle]] via a subaortic infundibulum and the [[pulmonary artery]] arises from the morphologic [[left ventricle]], without a subpulmonary infundibulum. | |||
**These ventriculoarterial connection is known as ventriculoarterial discordance. | |||
**As a consequence, there is a a fibrous continuity between the mitral and [[pulmonary valve]], but no continuity between the [[tricuspid]] and [[aortic valve]]. | |||
**The abnormal origin of the [[great arteries]] results in an altered spiral relationship. | |||
**Therefore, the [[aorta]] and [[pulmonary artery]] run parallel to each other | |||
**In normal [[heart]] thus the circulation is in series. | |||
**However, in transposition of the great vessels [[circulation]] is in parallel | |||
*[[Truncus arteriosus]] | |||
**In [[truncus arteriosus]], the [[pulmonary arteries]] are connected to the [[aorta]]. | |||
**A decrease in [[PVR]] at birth causes a left to right shunt with evidence of [[congestive heart failure]]. | |||
**These [[Patient|patients]] have a very high [[incidence]] of [[pulmonary hypertension]] and vascular disease. | |||
*[[Ebstein's anomaly]] | |||
**[[Pathophysiology]] mainly involves the [[right ventricle]], [[right atrium]] and [[Tricuspid valves|tricuspid valve]]: | |||
*** Failure of TV([[Tricuspid valves|tricuspid valve]]) leaflet delamination | |||
*** Apical descent of the functional [[Tricuspid|tricuspid orifice]] | |||
***[[Right ventricular dilation]] and “atrialization” | |||
*** Anterior leaflet abnormal [[fenestrations]] and tethering | |||
***[[Right atrioventricular orifice|Right atrioventricular junction]] dilation | |||
== Differential diagnosis == | == Differential diagnosis == | ||
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! rowspan="20" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary disease|Pulmonary diseases]] | ! rowspan="20" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary disease|Pulmonary diseases]] | ||
! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Airway]] disorder | ! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Airway]] disorder | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Severe [[croup]]<ref name="Cherry20082">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Intercostal]] and [[subcostal]] [[retraction]], [[Barking cough]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Intercostal]] and [[subcostal]] [[retraction]], [[Barking cough]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Epiglottitis]]<ref name="pmid23162404">{{cite journal| author=Abdallah C| title=Acute epiglottitis: Trends, diagnosis and management. | journal=Saudi J Anaesth | year= 2012 | volume= 6 | issue= 3 | pages= 279-81 | pmid=23162404 | doi=10.4103/1658-354X.101222 | pmc=3498669 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23162404 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Muffled voice, [[Drooling]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Muffled voice, [[Drooling]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Foreign body aspiration]]<ref name="pmid18682760">{{cite journal| author=Qureshi A, Behzadi A| title=Foreign-body aspiration in an adult. | journal=Can J Surg | year= 2008 | volume= 51 | issue= 3 | pages= E69-70 | pmid=18682760 | doi= | pmc=2496600 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18682760 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Mediastinitis]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Mediastinitis]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Bacterial tracheitis]]<ref name="pmid6869336">{{cite journal |vauthors=Liston SL, Gehrz RC, Siegel LG, Tilelli J |title=Bacterial tracheitis |journal=Am. J. Dis. Child. |volume=137 |issue=8 |pages=764–7 |date=August 1983 |pmid=6869336 |doi= |url=}}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Brassy [[cough]], [[Hoarseness]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Brassy [[cough]], [[Hoarseness]] | ||
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! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Sleep apnea]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Sleep apnea]]<ref name="pmid26336596">{{cite journal| author=Spicuzza L, Caruso D, Di Maria G| title=Obstructive sleep apnoea syndrome and its management. | journal=Ther Adv Chronic Dis | year= 2015 | volume= 6 | issue= 5 | pages= 273-85 | pmid=26336596 | doi=10.1177/2040622315590318 | pmc=4549693 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26336596 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Nightmares]], [[Snoring]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Nightmares]], [[Snoring]] | ||
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! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Chronic [[bronchitis]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |Chronic [[bronchitis]]<ref name="pmid23204254">{{cite journal| author=Kim V, Criner GJ| title=Chronic bronchitis and chronic obstructive pulmonary disease. | journal=Am J Respir Crit Care Med | year= 2013 | volume= 187 | issue= 3 | pages= 228-37 | pmid=23204254 | doi=10.1164/rccm.201210-1843CI | pmc=4951627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23204254 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Productive cough]], [[Chest tightness]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Productive cough]], [[Chest tightness]] | ||
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! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atelectasis]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atelectasis]]<ref name="pmid12531090">{{cite journal |vauthors=Peroni DG, Boner AL |title=Atelectasis: mechanisms, diagnosis and management |journal=Paediatr Respir Rev |volume=1 |issue=3 |pages=274–8 |date=September 2000 |pmid=12531090 |doi=10.1053/prrv.2000.0059 |url=}}</ref> | ||
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! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Parenchymal lung disease|Parenchymal disorder]] | ! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Parenchymal lung disease|Parenchymal disorder]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Alveolitis]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Alveolitis]]<ref name="pmid1620846">{{cite journal |vauthors=Lee JS, Im JG, Ahn JM, Kim YM, Han MC |title=Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT |journal=Radiology |volume=184 |issue=2 |pages=451–4 |date=August 1992 |pmid=1620846 |doi=10.1148/radiology.184.2.1620846 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Malaise]], [[Chills]], [[Headache]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Malaise]], [[Chills]], [[Headache]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Bradycardia]] ([[Legionella]]) | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Bradycardia]] ([[Legionella]]) | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late) | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Asthma]] (Late)<ref name="pmid19365260">{{cite journal |vauthors=Litonjua AA |title=Childhood asthma may be a consequence of vitamin D deficiency |journal=Curr Opin Allergy Clin Immunol |volume=9 |issue=3 |pages=202–7 |date=June 2009 |pmid=19365260 |doi=10.1097/ACI.0b013e32832b36cd |url=}}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Triad of [[asthma]], [[nasal polyps]], and [[rash]] is indicative of [[Aspirin desensitization|aspirin sensitivity]]. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Triad of [[asthma]], [[nasal polyps]], and [[rash]] is indicative of [[Aspirin desensitization|aspirin sensitivity]]. | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cystic fibrosis]]<ref name="urlCystic fibrosis - Genetics Home Reference">{{cite web |url=https://ghr.nlm.nih.gov/condition/cystic-fibrosis |title=Cystic fibrosis - Genetics Home Reference |format= |work= |accessdate=}}</ref> | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[COPD]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[COPD]] | ||
(Severe [[emphysema]]) | (Severe [[emphysema]])<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pulmonary hypertension]], [[Right heart failure]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pulmonary hypertension]], [[Right heart failure]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tuberculosis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tuberculosis]]<ref name="OlalekanOluwaseun2015">{{cite journal|last1=Olalekan|first1=Adebimpe Wasiu|last2=Oluwaseun|first2=Faremi Ayodeji|last3=Oladele|first3=Hassan Abdul-Wasiu|last4=Akeem|first4=Adeyemi Damilare|title=Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria|journal=Alexandria Journal of Medicine|volume=51|issue=3|year=2015|pages=255–260|issn=20905068|doi=10.1016/j.ajme.2014.10.003}}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Loss of appetite]], [[Night sweats]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Loss of appetite]], [[Night sweats]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary fibrosis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary fibrosis]]<ref name="pmid29268540">{{cite journal| author=Shaw J, Marshall T, Morris H, Hayton C, Chaudhuri N| title=Idiopathic pulmonary fibrosis: a holistic approach to disease management in the antifibrotic age. | journal=J Thorac Dis | year= 2017 | volume= 9 | issue= 11 | pages= 4700-4707 | pmid=29268540 | doi=10.21037/jtd.2017.10.111 | pmc=5721024 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29268540 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Weight loss]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Weight loss]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumoconiosis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumoconiosis]]<ref name="pmid27336897">{{cite journal| author=Yen CM, Lin CL, Lin MC, Chen HY, Lu NH, Kao CH| title=Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 25 | pages= e3972 | pmid=27336897 | doi=10.1097/MD.0000000000003972 | pmc=4998335 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27336897 }}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tightness in the [[chest]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tightness in the [[chest]] | ||
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! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lung cancer]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lung cancer]]<ref name="pmid20493989">{{cite journal |vauthors=Hartwig MG, D'Amico TA |title=Thoracoscopic lobectomy: the gold standard for early-stage lung cancer? |journal=Ann. Thorac. Surg. |volume=89 |issue=6 |pages=S2098–101 |date=June 2010 |pmid=20493989 |doi=10.1016/j.athoracsur.2010.02.102 |url=}}</ref> | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Weight loss]], [[Loss of appetite]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Weight loss]], [[Loss of appetite]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute respiratory distress syndrome]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acute respiratory distress syndrome]]<ref name="pmid26045965">{{cite journal| author=Ochiai R| title=Mechanical ventilation of acute respiratory distress syndrome. | journal=J Intensive Care | year= 2015 | volume= 3 | issue= 1 | pages= 25 | pmid=26045965 | doi=10.1186/s40560-015-0091-6 | pmc=4456061 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26045965 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 379: | Line 411: | ||
|- | |- | ||
! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary vascular congestion|Pulmonary vascular disorders]] | ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary vascular congestion|Pulmonary vascular disorders]] | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Massive [[pulmonary embolism]]<ref name="pmid23940438">{{cite journal| author=Bĕlohlávek J, Dytrych V, Linhart A| title=Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 129-38 | pmid=23940438 | doi= | pmc=3718593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940438 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Shock]], [[Pulmonary hypertension]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachycardia]], [[Shock]], [[Pulmonary hypertension]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary arterio-venous malformation]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary arterio-venous malformation]]<ref name="pmid119300212">{{cite journal |vauthors=Khurshid I, Downie GH |title=Pulmonary arteriovenous malformation |journal=Postgrad Med J |volume=78 |issue=918 |pages=191–7 |year=2002 |pmid=11930021 |pmc=1742331 |doi= |url=}}</ref><ref name="pmid195683982">{{cite journal |vauthors=Doshi HM, Robinson S, Chalhoub T, Jack S, Denison A, Gibson G |title=Massive spontaneous hemothorax during the immediate postpartum period |journal=Tex Heart Inst J |volume=36 |issue=3 |pages=247–9 |year=2009 |pmid=19568398 |pmc=2696501 |doi= |url=}}</ref><ref name="pmid15541322">{{cite journal |vauthors=Chanatry BJ |title=Acute hemothorax owing to pulmonary arteriovenous malformation in pregnancy |journal=Anesth. Analg. |volume=74 |issue=4 |pages=613–5 |year=1992 |pmid=1554132 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 417: | Line 449: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cerebral arteriovenous malformation]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cerebral arteriovenous malformation]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary hypertension]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonary hypertension]]<ref name="pmid28241922">{{cite journal| author=Hoeper MM, Ghofrani HA, Grünig E, Klose H, Olschewski H, Rosenkranz S| title=Pulmonary Hypertension. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 5 | pages= 73-84 | pmid=28241922 | doi=10.3238/arztebl.2017.0073 | pmc=5331483 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28241922 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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|- | |- | ||
! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chest wall deformities|Chest wall disorders]] | ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Chest wall deformities|Chest wall disorders]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Flail chest]]<ref name="pmid17650694">{{cite journal |vauthors=Pettiford BL, Luketich JD, Landreneau RJ |title=The management of flail chest |journal=Thorac Surg Clin |volume=17 |issue=1 |pages=25–33 |date=February 2007 |pmid=17650694 |doi=10.1016/j.thorsurg.2007.02.005 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 458: | Line 490: | ||
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bruises]] over [[chest]] | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bruises]] over [[chest]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pneumothorax]]<ref name="pmid20872980">{{cite journal| author=Luh SP| title=Review: Diagnosis and treatment of primary spontaneous pneumothorax. | journal=J Zhejiang Univ Sci B | year= 2010 | volume= 11 | issue= 10 | pages= 735-44 | pmid=20872980 | doi=10.1631/jzus.B1000131 | pmc=2950234 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20872980 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 498: | Line 530: | ||
! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiac disease|Cardiac diseases]] | ! rowspan="15" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiac disease|Cardiac diseases]] | ||
! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Congenital disorder|Congenital disorders]] | ! rowspan="8" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Congenital disorder|Congenital disorders]] | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrioventricular canal defect (patient information)|Atrioventricular canal defect]]<ref name="pmid15227445">{{cite journal| author=Macris MP, Ott DA, Cooley DA| title=Complete atrioventricular canal defect: surgical considerations. | journal=Tex Heart Inst J | year= 1992 | volume= 19 | issue= 3 | pages= 239-43 | pmid=15227445 | doi= | pmc=326195 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15227445 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], Lack of [[appetite]], [[Pale skin color]], Excessive [[sweating]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], Lack of [[appetite]], [[Pale skin color]], Excessive [[sweating]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ebstein anomaly]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ebstein anomaly]]<ref name="pmid27439413">{{cite journal |vauthors=Safi LM, Liberthson RR, Bhatt A |title=Current Management of Ebstein's Anomaly in the Adult |journal=Curr Treat Options Cardiovasc Med |volume=18 |issue=9 |pages=56 |date=September 2016 |pmid=27439413 |doi=10.1007/s11936-016-0478-2 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Palpitations]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Palpitations]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tetralogy of Fallot]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Tetralogy of Fallot]]<ref name="pmid19144126">{{cite journal| author=Bailliard F, Anderson RH| title=Tetralogy of Fallot. | journal=Orphanet J Rare Dis | year= 2009 | volume= 4 | issue= | pages= 2 | pmid=19144126 | doi=10.1186/1750-1172-4-2 | pmc=2651859 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19144126 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonic stenosis]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pulmonic stenosis]]<ref name="pmid23807889">{{cite journal| author=Yoo BW, Park HK| title=Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair. | journal=Korean J Pediatr | year= 2013 | volume= 56 | issue= 6 | pages= 235-41 | pmid=23807889 | doi=10.3345/kjp.2013.56.6.235 | pmc=3693041 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23807889 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Palpitation]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Total anomalous pulmonary venous drainage|Total anomalous pulmonary]] [[Total anomalous pulmonary venous drainage|venous connection]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Total anomalous pulmonary venous drainage|Total anomalous pulmonary]] [[Total anomalous pulmonary venous drainage|venous connection]]<ref name="pmid17352891">{{cite journal |vauthors=Stein P |title=Total anomalous pulmonary venous connection |journal=AORN J |volume=85 |issue=3 |pages=509–20; quiz 521–4 |date=March 2007 |pmid=17352891 |doi=10.1016/S0001-2092(07)60123-9 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Pounding [[heart]], Weak [[pulse]], Extreme [[sleepiness]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Pounding [[heart]], Weak [[pulse]], Extreme [[sleepiness]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Transposition of the great vessels]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Transposition of the great vessels]]<ref name="pmid18851735">{{cite journal| author=Martins P, Castela E| title=Transposition of the great arteries. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue= | pages= 27 | pmid=18851735 | doi=10.1186/1750-1172-3-27 | pmc=2577629 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18851735 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 612: | Line 644: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lack of appetite]], [[Poor weight gain]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lack of appetite]], [[Poor weight gain]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Truncus arteriosus]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Truncus arteriosus]]<ref name="pmid2856609">{{cite journal |vauthors=Van Praagh R |title=Truncus arteriosus: what is it really and how should it be classified? |journal=Eur J Cardiothorac Surg |volume=1 |issue=2 |pages=65–70 |date=1987 |pmid=2856609 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 631: | Line 663: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Sweating]], [[Pale skin|Pale]] or cool [[skin]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fatigue]], [[Sweating]], [[Pale skin|Pale]] or cool [[skin]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Patent ductus arteriosus]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Patent ductus arteriosus]]<ref name="urlPatent Ductus Arteriosus - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023293/. |title=Patent Ductus Arteriosus - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 651: | Line 683: | ||
|- | |- | ||
! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acquired disorder|Acquired disorders]] | ! rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Acquired disorder|Acquired disorders]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart failure]]<ref name="pmid27367736">{{cite journal| author=Inamdar AA, Inamdar AC| title=Heart Failure: Diagnosis, Management and Utilization. | journal=J Clin Med | year= 2016 | volume= 5 | issue= 7 | pages= | pmid=27367736 | doi=10.3390/jcm5070062 | pmc=4961993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27367736 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 670: | Line 702: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Generalized edema]], [[Hepatomegaly]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Generalized edema]], [[Hepatomegaly]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Valvular heart disease]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Valvular heart disease]]<ref name="pmid20435842">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 689: | Line 721: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Palpitation]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Palpitation]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial infarction]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myocardial infarction]]<ref name="urlMyocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023216/ |title=Myocardial Infarction (Heart Attack): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 708: | Line 740: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Fatigue]], [[Lightheadedness]], [[Cold sweat]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Fatigue]], [[Lightheadedness]], [[Cold sweat]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiogenic shock]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiogenic shock]]<ref name="pmid22675405">{{cite journal| author=Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA et al.| title=Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline. | journal=Dtsch Arztebl Int | year= 2012 | volume= 109 | issue= 19 | pages= 343-51 | pmid=22675405 | doi=10.3238/arztebl.2012.0343 | pmc=3364528 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22675405 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 727: | Line 759: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], [[Palpitation]], [[Hypotension]], Weak [[pulse]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tachypnea]], [[Palpitation]], [[Hypotension]], Weak [[pulse]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiomyopathy]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiomyopathy]]<ref name="pmid28912181">{{cite journal |vauthors=Marian AJ, Braunwald E |title=Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy |journal=Circ. Res. |volume=121 |issue=7 |pages=749–770 |date=September 2017 |pmid=28912181 |doi=10.1161/CIRCRESAHA.117.311059 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Arrhythmias|Arrhythmia]], [[Bloating]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Arrhythmias|Arrhythmia]], [[Bloating]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart tumors]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Heart tumors]]<ref name="pmid24717305">{{cite journal| author=Hoffmeier A, Sindermann JR, Scheld HH, Martens S| title=Cardiac tumors--diagnosis and surgical treatment. | journal=Dtsch Arztebl Int | year= 2014 | volume= 111 | issue= 12 | pages= 205-11 | pmid=24717305 | doi=10.3238/arztebl.2014.0205 | pmc=3983698 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24717305 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 765: | Line 797: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Weight loss]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Syncope]], [[Weight loss]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mitral Stenosis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mitral Stenosis]]<ref name="pmid21189882">{{cite journal| author=Kannan M, Vijayanand G| title=Mitral stenosis and pregnancy: Current concepts in anaesthetic practice. | journal=Indian J Anaesth | year= 2010 | volume= 54 | issue= 5 | pages= 439-44 | pmid=21189882 | doi=10.4103/0019-5049.71043 | pmc=2991654 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21189882 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 786: | Line 818: | ||
! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Vascular disease]] | ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Vascular disease]] | ||
! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial Insufficiency|Arterial disorders]] | ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial Insufficiency|Arterial disorders]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ddx:Acrocyanosis|Acrocyanosis]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ddx:Acrocyanosis|Acrocyanosis]]<ref name="pmid24249890">{{cite journal| author=Das S, Maiti A| title=Acrocyanosis: an overview. | journal=Indian J Dermatol | year= 2013 | volume= 58 | issue= 6 | pages= 417-20 | pmid=24249890 | doi=10.4103/0019-5154.119946 | pmc=3827510 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24249890 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 805: | Line 837: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Brittle nails]], [[Telangiectasia]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Brittle nails]], [[Telangiectasia]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial embolism]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Arterial embolism]]<ref name="pmid23724391">{{cite journal| author=Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ| title=Arterial embolism. | journal=Int J Crit Illn Inj Sci | year= 2013 | volume= 3 | issue= 1 | pages= 77-87 | pmid=23724391 | doi=10.4103/2229-5151.109429 | pmc=3665125 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23724391 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 824: | Line 856: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], Decreased [[sensation]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], Decreased [[sensation]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Raynaud's Phenomenon]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Raynaud's Phenomenon]]<ref name="pmid11438158">{{cite journal |vauthors=Block JA, Sequeira W |title=Raynaud's phenomenon |journal=Lancet |volume=357 |issue=9273 |pages=2042–8 |date=June 2001 |pmid=11438158 |doi=10.1016/S0140-6736(00)05118-7 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 844: | Line 876: | ||
|- | |- | ||
! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous insufficiency|Venous disorders]] | ! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous insufficiency|Venous disorders]] | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Superior vena cava obstruction]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Superior vena cava obstruction]]<ref name="pmid22477372">{{cite journal| author=Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N| title=Superior vena cava syndrome: A medical emergency? | journal=Int J Angiol | year= 2008 | volume= 17 | issue= 1 | pages= 43-6 | pmid=22477372 | doi= | pmc=2728369 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22477372 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 865: | Line 897: | ||
[[Facial]] [[swelling]] | [[Facial]] [[swelling]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous stasis]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Venous stasis]]<ref name="pmid21326688">{{cite journal| author=Fan CM| title=Venous pathophysiology. | journal=Semin Intervent Radiol | year= 2005 | volume= 22 | issue= 3 | pages= 157-61 | pmid=21326688 | doi=10.1055/s-2005-921949 | pmc=3036287 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21326688 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 906: | Line 938: | ||
|- | |- | ||
! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hematologic diseases]] | ! colspan="2" rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hematologic diseases]] | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Methemoglobinemia]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Methemoglobinemia]]<ref name="pmid21954509">{{cite journal |vauthors=Ashurst J, Wasson M |title=Methemoglobinemia: a systematic review of the pathophysiology, detection, and treatment |journal=Del Med J |volume=83 |issue=7 |pages=203–8 |date=July 2011 |pmid=21954509 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], [[Altered mental status]], [[Delirium]], [[Seizure]], [[Coma]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Headache]], [[Altered mental status]], [[Delirium]], [[Seizure]], [[Coma]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polycythemia]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polycythemia]]<ref name="pmid11841424">{{cite journal |vauthors=Spivak JL |title=The optimal management of polycythaemia vera |journal=Br. J. Haematol. |volume=116 |issue=2 |pages=243–54 |date=February 2002 |pmid=11841424 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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|- | |- | ||
! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]] | ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Breath-holding spells]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Breath-holding spells]]<ref name="pmid25676645">{{cite journal| author=Goldman RD| title=Breath-holding spells in infants. | journal=Can Fam Physician | year= 2015 | volume= 61 | issue= 2 | pages= 149-50 | pmid=25676645 | doi= | pmc=4325862 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25676645 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Twitching|Twitching muscles]], [[Seizure]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Twitching|Twitching muscles]], [[Seizure]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Seizure]]<ref name="pmid20689626">{{cite journal| author=Goldenberg MM| title=Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment. | journal=P T | year= 2010 | volume= 35 | issue= 7 | pages= 392-415 | pmid=20689626 | doi= | pmc=2912003 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20689626 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Tonic-clonic|Tonic-clonic movements]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fainting]], [[Tonic-clonic|Tonic-clonic movements]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Coma]]<ref name="pmid21190458">{{cite journal| author=Brown EN, Lydic R, Schiff ND| title=General anesthesia, sleep, and coma. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 27 | pages= 2638-50 | pmid=21190458 | doi=10.1056/NEJMra0808281 | pmc=3162622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21190458 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 1,002: | Line 1,034: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Depressed [[brainstem]] reflexes, [[Agonal breathing]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Depressed [[brainstem]] reflexes, [[Agonal breathing]] | ||
|- | |- | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Head trauma]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Head trauma]]<ref name="pmid22033563">{{cite journal| author=McAllister TW| title=Neurobiological consequences of traumatic brain injury. | journal=Dialogues Clin Neurosci | year= 2011 | volume= 13 | issue= 3 | pages= 287-300 | pmid=22033563 | doi= | pmc=3182015 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22033563 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 1,022: | Line 1,054: | ||
|- | |- | ||
! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous | ! colspan="2" rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Miscellaneous | ||
! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[High altitude exposure]] | ! colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[High altitude exposure]]<ref name="pmid29340578">{{cite journal |vauthors=Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C |title=Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions |journal=Eur. Heart J. |volume= |issue= |pages= |date=January 2018 |pmid=29340578 |doi=10.1093/eurheartj/ehx720 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
Line 1,041: | Line 1,073: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Coma]], Death | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dizziness]], [[Coma]], Death | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Septic shock]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Septic shock]]<ref name="pmid28117397">{{cite journal| author=Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL| title=Sepsis and septic shock. | journal=Nat Rev Dis Primers | year= 2016 | volume= 2 | issue= | pages= 16045 | pmid=28117397 | doi=10.1038/nrdp.2016.45 | pmc=5538252 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28117397 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
Line 1,060: | Line 1,092: | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Chills]], [[Hypothermia]], [[Loss of consciousness]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Chills]], [[Hypothermia]], [[Loss of consciousness]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Smoke inhalation]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Smoke inhalation]]<ref name="pmid20161170">{{cite journal| author=Rehberg S, Maybauer MO, Enkhbaatar P, Maybauer DM, Yamamoto Y, Traber DL| title=Pathophysiology, management and treatment of smoke inhalation injury. | journal=Expert Rev Respir Med | year= 2009 | volume= 3 | issue= 3 | pages= 283-297 | pmid=20161170 | doi=10.1586/ERS.09.21 | pmc=2722076 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20161170 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +/- | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cough]], [[Hoarseness]], [[Hemoptysis]], [[Headache]], [[Fainting]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cough]], [[Hoarseness]], [[Hemoptysis]], [[Headache]], [[Fainting]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cold exposure]] | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cold exposure]]<ref>{{cite book | last = Marriott | first = Bernadette | title = Nutritional needs in cold and in high-altitude environments : applications for military personnel in field operations | publisher = National Academy Press | location = Washington, D.C | year = 1996 | isbn = 0-309-05484-2 }}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - |
Latest revision as of 19:15, 14 April 2020
Congenital cyanotic heart disease Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D. Eiman Ghaffarpasand, M.D. [2]
Overview
Congenital cyanotic heart disease is a group of heart defects that will causes neonatal cyanosis. The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries. Such defects include persistent truncus arteriosus, total anomalous pulmonary venous connection, tetralogy of Fallot, transposition of the great vessels, and Ebstein's anomaly.
Classification
Congenital cyanotic heart disease may be classified according to anatomical defect into 5 subgroups:
- Tetralogy of fallot
- It is understood that tetralogy of fallot is the result of improper positioning of the outlet septum.
- In the normal heart, the outlet septum is an indistinguishable component of the crista supraventricularis that communicates with the septomarginal trabeculae to divide the right and left ventricular cavities.
- In Tetralogy of Fallot, proper ventricular septation is perturbed by anterocephalad displacement of the outlet septum relative to the septomarginal trabecula.
- The direct consequence of this misalignment is an overriding aortic orifice and a ventricular septal defect, resulting in an intracardiac right to left shunt of blood.
- In addition, anterocephalad displacement of the outlet septum indirectly predisposes the pulmonary trunk to stenosis in the setting of septoparietal trabecular hypertrophy.
- Together, the displacement of the outlet septum coupled with the hypertrophic arrangement of the septoparietal trabeculae account for the three anatomical cardinal defects in Tetralogy of Fallot - aortic dextroposition, interventricular communication (VSD), and pulmonary stenosis.
- The fourth defect - right ventricular hypertrophy - is a hemodynamic consequence of these three morphologic changes, as the right ventricle physiologically adapts to the increased resistance of a stenotic pulmonary trunk.
- Total anomalous pulmonary venous connection
- n this condition,the right side of heart is receiving blood both from pulmonary and systemic circulation.
- There is a mixing of oxygenated pulmonary venous blood with deoxygenated blood from systemic circulation.
- The mixing of blood could occur at three levels i.e. supracardiac, infracardiac and cardiac.
- In the former two the mixing occurs outside the heart and in latter inside the heart (right atrium).
- Transposition of the great arteries
- In the TGA the aorta arises from the morphologic right ventricle via a subaortic infundibulum and the pulmonary artery arises from the morphologic left ventricle, without a subpulmonary infundibulum.
- These ventriculoarterial connection is known as ventriculoarterial discordance.
- As a consequence, there is a a fibrous continuity between the mitral and pulmonary valve, but no continuity between the tricuspid and aortic valve.
- The abnormal origin of the great arteries results in an altered spiral relationship.
- Therefore, the aorta and pulmonary artery run parallel to each other
- In normal heart thus the circulation is in series.
- However, in transposition of the great vessels circulation is in parallel
- Truncus arteriosus
- In truncus arteriosus, the pulmonary arteries are connected to the aorta.
- A decrease in PVR at birth causes a left to right shunt with evidence of congestive heart failure.
- These patients have a very high incidence of pulmonary hypertension and vascular disease.
- Ebstein's anomaly
- Pathophysiology mainly involves the right ventricle, right atrium and tricuspid valve:
- Failure of TV(tricuspid valve) leaflet delamination
- Apical descent of the functional tricuspid orifice
- Right ventricular dilation and “atrialization”
- Anterior leaflet abnormal fenestrations and tethering
- Right atrioventricular junction dilation
- Pathophysiology mainly involves the right ventricle, right atrium and tricuspid valve:
Differential diagnosis
Congenital cyanotic heart disease should be differentiated from other conditions that causes cyanosis:
References
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