Transposition of the great vessels history and symptoms
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Transposition of the great vessels Microchapters |
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Classification |
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Differentiating Transposition of the great vessels from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]
Overview
History
- Cyanosis can seen soon after the birth, due to the low oxygen saturation of the blood.
- Peripheral areas such as around the mouth and lips, fingertips, and toes are affected first because they are furthest from the heart, and since the circulated blood is not fully oxygenated to begin with, very little oxygen reaches the peripheral arteries.
- Screening ultrasounds do not routinely reveal TGA in-utero.
Symptoms
- The clinical features of D-TGA are solely dependent on the degree of mixing between the parallel circuits.[1]
- Most patients present with signs and symptoms during the neonatal period (first 30 days of life).
The following are the typical clinical manifestations of TGA:
- Cyanosis
- Tachypnea
- Patients usually have a respiratory rate higher than 60 breaths per minute but without retractions, grunting, or flaring and appear comfortable.
- Murmurs
- Murmurs are not typically present unless a small VSD or pulmonic stenosis exists.[3]
- A murmur resulting from a VSD will be pansystolic and prominent at the lower left sternal border.
- Pulmonic stenosis causes a systolic ejection murmur at the upper left sternal border.
- Patients with L-TGA are typically unaffected until later in life when the right ventricle can no longer compensate for the increased afterload of the systemic circulation. These patients present with signs and symptoms of heart failure.
- Other non-specific symptoms include:
References
- ↑ Warnes CA (December 2006). "Transposition of the great arteries". Circulation. 114 (24): 2699–709. doi:10.1161/CIRCULATIONAHA.105.592352. PMID 17159076.
- ↑ Oster ME, Aucott SW, Glidewell J, Hackell J, Kochilas L, Martin GR, Phillippi J, Pinto NM, Saarinen A, Sontag M, Kemper AR (May 2016). "Lessons Learned From Newborn Screening for Critical Congenital Heart Defects". Pediatrics. 137 (5). doi:10.1542/peds.2015-4573. PMC 5227333. PMID 27244826.
- ↑ Van Praagh R, Geva T, Kreutzer J (November 1989). "Ventricular septal defects: how shall we describe, name and classify them?". J. Am. Coll. Cardiol. 14 (5): 1298–9. doi:10.1016/0735-1097(89)90431-2. PMID 2808986.