Tricuspid atresia differential diagnosis: Difference between revisions

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==Differentiating Tricuspid Atresia from other Diseases==
==Differentiating Tricuspid Atresia from other Diseases==
Patients with tricuspid atresia should be differentiated from other cardiac and non-cardiac causes of [[cyanosis]].
<br />
 
== Differentiating tricuspid atresia from other Diseases ==
 
 
 
Patients with tricuspid atresia should be differentiated from other cardiac causes of [[cyanosis]] and olygemia include:
 


Cardiac causes (starts with 't'):
* [[Tetralogy of Fallot]]
* [[Tetralogy of Fallot]]
* [[Truncus arteriosus]]
* [[Truncus arteriosus]]
* [[Total anomalous pulmonary venous connection]]
* [[Total anomalous pulmonary venous connection]]
* Other tricuspid valve abnormalities like [[tricuspid regurgitaton]], [[tricuspid stenosis]]
* [[Pulmonary atresia]],  
 
* [[Hypoplastic left heart syndrome]],
Other less common causes are- [[pulmonary atresia]], [[hypoplastic left heart syndrome]], anomalous systemic venous connection.
* [[Anomalous systemic venous connection}}.
 
* [[Tricuspid atresia]]
Non-cardiac causes:
* [[Pulmonary disease]]s - Structural abnormalities of the lung, V/P ([[ventilation-perfusion mismatch]]), [[airway obstruction]], [[pneumothorax]], and [[hypoventilation]].
* [[Abnormal hemoglobin]] like [[methemoglobin]], [[polycythemia]]
* Peripheral [[cyanosis]] for e.g. [[sepsis]], [[hypoglycemia]], [[dehydration]], and [[hypoadrenalism]].


Table below compares [[Congenital heart disease cyanotic|cyanotic heart]] diseases:
Table below compares [[Congenital heart disease cyanotic|cyanotic heart]] diseases:
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |X-Ray Findings
! align="center" style="background:#4479BA; color: #FFFFFF;" + |X-Ray Findings
|-
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tetralogy of Fallot]]''' <ref name="MorrisFelner1975">{{cite journal|last1=Morris|first1=Douglas C.|last2=Felner|first2=Joel M.|last3=Schlant|first3=Robert C.|last4=Franch|first4=Robert H.|title=Echocardiographic diagnosis of tetralogy of Fallot|journal=The American Journal of Cardiology|volume=36|issue=7|year=1975|pages=908–913|issn=00029149|doi=10.1016/0002-9149(75)90081-8}}</ref><ref name="pmid1428277">{{cite journal |vauthors=Kothari SS |title=Mechanism of cyanotic spells in tetralogy of Fallot--the missing link? |journal=Int. J. Cardiol. |volume=37 |issue=1 |pages=1–5 |date=October 1992 |pmid=1428277 |doi=10.1016/0167-5273(92)90125-m |url=}}</ref>
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tetralogy of Fallot]]'''  
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial


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* [[Pulmonary]] vascular marking may be normal or decreased
* [[Pulmonary]] vascular marking may be normal or decreased
|-
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Total anomalous pulmonary venous connection|Total Anomalous Pulmonary Venous Connection]]''' <ref name="ZhangZhang2016">{{cite journal|last1=Zhang|first1=Ziming|last2=Zhang|first2=Li|last3=Xie|first3=Feng|last4=Wang|first4=Bing|last5=Sun|first5=Zhengxing|last6=Kong|first6=Shuangshuang|last7=Wang|first7=Xinfang|last8=Dong|first8=Nianguo|last9=Wang|first9=Guohua|last10=Lv|first10=Qing|last11=Li|first11=Yuman|last12=Li|first12=Ling|last13=Xie|first13=Mingxing|title=Echocardiographic diagnosis of anomalous pulmonary venous connections|journal=Medicine|volume=95|issue=44|year=2016|pages=e5389|issn=0025-7974|doi=10.1097/MD.0000000000005389}}</ref><ref name="pmid389559">{{cite journal |vauthors=Chen JT |title=Radiologic demonstration of anomalous pulmonary venous connection and its clinical significance |journal=CRC Crit Rev Diagn Imaging |volume=11 |issue=4 |pages=383–422 |date=October 1979 |pmid=389559 |doi= |url=}}</ref><ref name="GathmanNadas1970">{{cite journal|last1=Gathman|first1=Gary E.|last2=Nadas|first2=Alexander S.|title=Total Anomalous Pulmonary Venous Connection|journal=Circulation|volume=42|issue=1|year=1970|pages=143–154|issn=0009-7322|doi=10.1161/01.CIR.42.1.143}}</ref>
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Total anomalous pulmonary venous connection|Total Anomalous Pulmonary Venous Connection]]'''  


| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
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* The classic '''snowman''' sign is seen in supracardiac subtype
* The classic '''snowman''' sign is seen in supracardiac subtype
|-
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tricuspid atresia|Tricuspid Atresia]]''' <ref name="BeppuNimura1978">{{cite journal|last1=Beppu|first1=S|last2=Nimura|first2=Y|last3=Tamai|first3=M|last4=Nagata|first4=S|last5=Matsuo|first5=H|last6=Kawashima|first6=Y|last7=Kozuka|first7=T|last8=Sakakibara|first8=H|title=Two-dimensional echocardiography in diagnosing tricuspid atresia. Differentiation from other hypoplastic right heart syndromes and common atrioventricular canal.|journal=Heart|volume=40|issue=10|year=1978|pages=1174–1183|issn=1355-6037|doi=10.1136/hrt.40.10.1174}}</ref><ref name="pmid7049815">{{cite journal |vauthors=Thiene G, Anderson RH |title=The clinical morphology of tricuspid atresia. Atresia of the right atrioventricular valve |journal=G Ital Cardiol |volume=11 |issue=12 |pages=1845–59 |date=1981 |pmid=7049815 |doi= |url=}}</ref>
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Tricuspid atresia|Tricuspid Atresia]]'''  
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial


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* [[Cardiac]] size may be normal or enlarged
* [[Cardiac]] size may be normal or enlarged
|-
|-
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Transposition of the great vessels|Transposition of the Great Arteries]]''' <ref name="MahleGonzalez2013">{{cite journal|last1=Mahle|first1=William T.|last2=Gonzalez|first2=Javier H.|last3=Kreeger|first3=Joseph|last4=Marx|first4=Gerald|last5=Duldani|first5=Gul|last6=Silverman|first6=Norman H.|title=Echocardiography of transposition of the great arteries|journal=Cardiology in the Young|volume=22|issue=6|year=2013|pages=664–670|issn=1047-9511|doi=10.1017/S1047951112001503}}</ref><ref name="Warnes2006">{{cite journal|last1=Warnes|first1=Carole A.|title=Transposition of the Great Arteries|journal=Circulation|volume=114|issue=24|year=2006|pages=2699–2709|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.105.592352}}</ref>
! style="padding: 5px 5px; background: #DCDCDC; " align="left"|'''[[Transposition of the great vessels|Transposition of the Great Arteries]]'''  
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
Multifactorial
Multifactorial
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Revision as of 11:09, 21 August 2020

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Differentiating Tricuspid Atresia from other Diseases


Differentiating tricuspid atresia from other Diseases

Patients with tricuspid atresia should be differentiated from other cardiac causes of cyanosis and olygemia include:


Table below compares cyanotic heart diseases:

Disorders Etiology Clinical Presentation Laboratory Findings Electrocardiogram Findings Echocardiography Findings X-Ray Findings
Tetralogy of Fallot Multifactorial

Echocardiography may show:

  • Residual VSD or ASD
  • RV outflow tract obstruction
  • Abnormal valvular anatomy
  • The boot-shaped heart appearance
  • Normal heart size
  • Pulmonary vascular marking may be normal or decreased
Total Anomalous Pulmonary Venous Connection Multifactorial
  • Prominence of the pulmonary arteries
  • Mild enlargement of heart
  • The classic snowman sign is seen in supracardiac subtype
Tricuspid Atresia Multifactorial
  • Respiratory difficulties as nasal flaring or muscle retractions
  • Cyanosis
  • Growth retradation
  • Tall P waves indicate atrial enlargement.
  • Frontal plane QRS axis may be leftward.
 Echocardiography may show
Transposition of the Great Arteries

Multifactorial

Echocardiography may show:

  • The classic egg on string appearance
  • Pulmonary vascular marking may be normal or increased

References

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