Total anomalous pulmonary venous connection differential diagnosis: Difference between revisions

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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Echocardiography
|-
|-
|'''[[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]]''' <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>
|Multifactorial
|Multifactorial


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* Maternal [[alcohol]] use
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
* Maternal [[diabetes]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Cyanosis]] on exertion
* [[Cyanosis]] on exertion
* [[Exertional dyspnea]]
* [[Exertional dyspnea]]
* [[Palpitation|Palpitations]]
* [[Palpitation|Palpitations]]
* [[Fatigue]]
* [[Fatigue]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* CBC: [[Anemia]] or [[polycythemia]].
* CBC: [[Anemia]] or [[polycythemia]].
* [[Coagulation]] profile.
* [[Coagulation]] profile.
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Right ventricular hypertrophy]]
*[[Right ventricular hypertrophy]]
*[[Right bundle branch block]]
*[[Right bundle branch block]]
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* Abnormal valvular anatomy
* Abnormal valvular anatomy
|-
|-
|'''[[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>
! 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>


|Multifactorial
|Multifactorial
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* Maternal [[alcohol]] use
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
* Maternal [[diabetes]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Tachypnea]]
* [[Tachypnea]]
* [[Palpitation|Palpitations]]
* [[Palpitation|Palpitations]]
* [[Cyanosis]]
* [[Cyanosis]]
* [[Failure to thrive]]
* [[Failure to thrive]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
* Arterial blood gas: Low [[oxygen saturation]] and [[acidosis]]
* [[Coagulation]] profile.
* [[Coagulation]] profile.
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Right ventricular hypertrophy]] with a qR pattern
* [[Right ventricular hypertrophy]] with a qR pattern
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Right ventricular hypertrophy]]
*[[Right ventricular hypertrophy]]
*Right ventricular loading
*Right ventricular loading
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*  
*  
|-
|-
|'''[[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]]''' <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>
|Multifactorial
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Multifactorial


*[[Polymorphism (biology)|Genetic polymorphisms]]
*[[Polymorphism (biology)|Genetic polymorphisms]]
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* Maternal [[alcohol]] use
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
* Maternal [[diabetes]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Respiratory difficulties  as nasal flaring or muscle retractions
* Respiratory difficulties  as nasal flaring or muscle retractions
* [[Cyanosis]]
* [[Cyanosis]]
* Growth retradation
* Growth retradation
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Arterial blood gas|Arterial blood gases]]
* [[Arterial blood gas|Arterial blood gases]]
* [[Complete blood count|CBC]]: [[Polycythemia]]
* [[Complete blood count|CBC]]: [[Polycythemia]]
* [[Coagulation]] profile
* [[Coagulation]] profile
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Tall [[P wave|P waves]] indicate atrial enlargement.
* Tall [[P wave|P waves]] indicate atrial enlargement.


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* Frontal plane [[QRS complex|QRS]] axis may be leftward.
* Frontal plane [[QRS complex|QRS]] axis may be leftward.
|Echocardiography may show
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Echocardiography may show


* Defect size
* Defect size
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* Valve abnormalities
* Valve abnormalities
|-
|-
|'''[[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]]''' <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>
|Multifactorial
|Multifactorial


Line 111: Line 111:
* Maternal [[alcohol]] use
* Maternal [[alcohol]] use
* Maternal [[diabetes]]
* Maternal [[diabetes]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Prominent [[cyanosis]] within hours of birth
* Prominent [[cyanosis]] within hours of birth
*[[Congestive heart failure]]
*[[Congestive heart failure]]
*  
*  
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Arterial blood gas|Arterial blood gases]]: [[Hypoxemia]]
*[[Arterial blood gas|Arterial blood gases]]: [[Hypoxemia]]
* Hyperoxia test
* Hyperoxia test
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Right ventricular hypertrophy]]
* [[Right ventricular hypertrophy]]


Revision as of 18:06, 21 February 2020


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS[4]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

Total anomalous pulmonary venous connection should be differentiated from other cyanotic congenital heart diseases found in the pediatrics population

Differentiating Total anomalous pulmonary venous connection from other Diseases

Disorders Etiology Clinical Presentation Laboratory Findings Electrocardiogram Echocardiography
Tetralogy of Fallot [1][2] Multifactorial Echocardiography may show:
  • Residual VSD or ASD
  • RV outflow tract obstruction
  • Abnormal valvular anatomy
Total Anomalous Pulmonary Venous Connection [3][4] Multifactorial
Tricuspid Atresia [5][6] 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 [7][8] Multifactorial Echocardiography may show:

References

  1. ↑ Morris, Douglas C.; Felner, Joel M.; Schlant, Robert C.; Franch, Robert H. (1975). "Echocardiographic diagnosis of tetralogy of Fallot". The American Journal of Cardiology. 36 (7): 908–913. doi:10.1016/0002-9149(75)90081-8. ISSN 0002-9149.
  2. ↑ Kothari SS (October 1992). "Mechanism of cyanotic spells in tetralogy of Fallot--the missing link?". Int. J. Cardiol. 37 (1): 1–5. doi:10.1016/0167-5273(92)90125-m. PMID 1428277.
  3. ↑ Zhang, Ziming; Zhang, Li; Xie, Feng; Wang, Bing; Sun, Zhengxing; Kong, Shuangshuang; Wang, Xinfang; Dong, Nianguo; Wang, Guohua; Lv, Qing; Li, Yuman; Li, Ling; Xie, Mingxing (2016). "Echocardiographic diagnosis of anomalous pulmonary venous connections". Medicine. 95 (44): e5389. doi:10.1097/MD.0000000000005389. ISSN 0025-7974.
  4. ↑ Chen JT (October 1979). "Radiologic demonstration of anomalous pulmonary venous connection and its clinical significance". CRC Crit Rev Diagn Imaging. 11 (4): 383–422. PMID 389559.
  5. ↑ Beppu, S; Nimura, Y; Tamai, M; Nagata, S; Matsuo, H; Kawashima, Y; Kozuka, T; Sakakibara, H (1978). "Two-dimensional echocardiography in diagnosing tricuspid atresia. Differentiation from other hypoplastic right heart syndromes and common atrioventricular canal". Heart. 40 (10): 1174–1183. doi:10.1136/hrt.40.10.1174. ISSN 1355-6037.
  6. ↑ Thiene G, Anderson RH (1981). "The clinical morphology of tricuspid atresia. Atresia of the right atrioventricular valve". G Ital Cardiol. 11 (12): 1845–59. PMID 7049815.
  7. ↑ Mahle, William T.; Gonzalez, Javier H.; Kreeger, Joseph; Marx, Gerald; Duldani, Gul; Silverman, Norman H. (2013). "Echocardiography of transposition of the great arteries". Cardiology in the Young. 22 (6): 664–670. doi:10.1017/S1047951112001503. ISSN 1047-9511.
  8. ↑ Warnes, Carole A. (2006). "Transposition of the Great Arteries". Circulation. 114 (24): 2699–2709. doi:10.1161/CIRCULATIONAHA.105.592352. ISSN 0009-7322.

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