Congenital Heart Disease CHD Clinical Manifestations : Truncus Arteriosus

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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CONGENITAL HEART DISEASE-AN OVERVIEW

Related topics

Prevalence,Etiology and Cardiac Malformations Genetic Causes of CHD

Cyanosis and Congestive Heart Failure and Cyanotic CHD

Obstructive Lesions of CHD

L -R Shunt Lesions of CHD

CHD Associated Anomalies

Dr N.C.Joshi
Consultant Pediatrician,
Consultant at Nanavati Hospital,
Ex Dean:-B.J.Wadia Children's Hospital.

Clinical manifestations :

Non-obstructive: similar to ASD
Obstructive: signs of pulmonary hypertension
EKG: RVH
Chest X-ray: "snowman heart"(50%)

Common forms of total anomalous pulmonary venous connection (TAPVC).

TAPVC to the left innominate vein (L Inn. V) by way of a vertical vein (VV).
TAPVC to coronary sinus (CS). The pulmonary veins join to form a confluence designated common pulmonary vein (CPV), which connects to the coronary sinus.
TAPVC to the portal vein (PV). The pulmonary veins form a confluence, from which an anomalous channel arises. This connects to the portal vein, which communicates with the inferior vena cava (IVC) by way of ductus venosus (DV) or the hepatic sinusoids.

SV- Splenic vein; SMV- superior mesenteric vein; RP and LP- right and left portal veins; RH and LH - right and left
hepatic veins; SVC- superior vena cava ; RA and LA- right and left atrium; RV and LV- right and left ventricle.

Truncus Arteriosus

Types:

MPA arises from the truncus
The pulmonary arteries arise from the posterior aspect of the truncus
The pulmonary arteries arise from the lateral aspect of the truncus
Bronchial arteries arise from the descending aorta

Anatomical types of persistent truncus arteriosus:

type I, the MPA arises from the truncus and then divides into the right and left pulmonary arteries.
type II, the pulmonary arteries arise from the posterior aspect to the truncus.
type III, the pulmonary arteries arise from the lateral aspects of the truncus.
type IV, or pseudotruncus arteriosus, bronchial arteries arising from the descending aorta and supplying the lungs.

Clinical manifestations :

In Type I- CHF
Others - cyanosis

Physical Examination :

Wide pulse pressure and bounding arterial pulses
Systolic click at the apex with harsh systolic murmur at the left lower sternal border
EKG: BVH or RVH
Chest X-rays: right- sided aortic arch (35-50%)

Treatment :

Medical
Surgical

Next : Clinical Manifestations of CHD(Contd.)

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