Presentation
Obstruction of the left ventricular out flow tract is present in 25% of patients. [pedclerk.bsd.uchicago.edu]
Stenosis of valves or vessels may also be present. When no other heart defects are present it is called 'simple' l-TGA; when other defects are present it is called 'complex' l-TGA. [en.wikipedia.org]
If the anomaly is complicated by right ventricular or tricuspid valve dysfunction, patients can present with exertional dyspnea and easy fatigability. [radiopaedia.org]
Case Presentation A 91-year-old woman presented to an outpatient clinic with a 6-month history of progressive shortness of breath on exertion. [consultant360.com]
CCTGA WITH LARGE VSD: these patients presents with features of CHF in childhood and second decade and 30% of such patients present in 3-4 months due to CHF. 3. [slideshare.net]
Entire Body System
- Cyanotic Congenital Heart Disease
It accounts for about 3 percent of all congenital heart disease. [pedclerk.bsd.uchicago.edu]
Cardiovascular
- Heart Murmur
However, if there are any other associated defects present such as pulmonary stenosis, then your child may have a heart murmur. The sound of extra blood being pushed towards the lungs and leaking through the valve can be heard as a heart murmur. [chfed.org.uk]
The congenital heart defect may go undetected for a long time. It might not be diagnosed until well into adulthood when congestive heart failure, heart murmurs and abnormal heart rhythms can develop. [heart.org]
Doctors often suspect a heart defect when they hear a heart murmur during an examination with a stethoscope, but usually they do echocardiography (ultrasonography of the heart) to confirm the diagnosis. [merckmanuals.com]
More research is needed into the causes of CCTGA and other congenital heart defects. How is CCTGA diagnosed? Some babies born with CCTGA have heart murmurs, heart rhythm problems, and/or show signs of heart failure. [achaheart.org]
- Vascular Disease
Learn more » Vascular Surgery Offering comprehensive care of vascular disease through preventive services, diagnostic expertise, minimally invasive therapies and traditional surgical techniques. [surgery.usc.edu]
[…] of the Aorta 1473 Noninvasive Assessment of Peripheral Vascular Disease 1496 Cerebrovascular Disease 1511 Disease of Peripheral Vessels 1531 Renal Artery Disease 1549 Venous Thromboembolism 1569 Index 1585 Genetic Factors in Atherosclerosis 1589 Gene [books.google.com]
基礎疾患、原疾患 unstable angina pectoris (UAP) 不安定狭心症 v vagotomy迷走神経切除 vagotonia迷走神経緊張 valve area弁口面積 valve replacement弁置換[術] valvular (heart) disease [心臓]弁膜症 valvuloplasty弁形成[術] vanishing tumor一過性腫瘤状陰影 variation変動 varicose veins 拡張蛇行静脈 vasa vasorum栄養血管 vascular [tokyo-med.ac.jp]
Psychiatrical
- Suggestibility
These findings are suggestive of the diffuse nature of conduction delay in this congenital lesion involving intra-atrial, AV nodal, and intra-His regions. [ncbi.nlm.nih.gov]
Anteroposterior thoracic roentgenograms may suggest the diagnosis, particularly when a narrow waist is present at the base of the heart, accompanied by the absence of a pulmonary-artery "knob" and the presence of an enlarged left atrium. [pediatrics.aappublications.org]
ECG: may suggest a correct diagnosis 25. Chest XRAY Narrow vascular pedicle ‘HUMP SHAPED’ appearance of left cardiac silhouette of right ventricle due to inverted infundibulum. [slideshare.net]
- Impulsivity
[…] contractility coronary artery curve decrease diagnosis diastolic digitalis diuretics drug dyspnea ectopic effect ejection electrocardiogram fibers fibrillation filling findings first fluid function gallop heart disease heart sound Hemodynamic hypertension hypertrophy impulse [books.google.com]
A blockage in the electrical conduction system: Hearts use an electrical impulse to make their muscles contract. In CCTGA the electrical conduction system can get “blocked” and patients may require a pacemaker. [chop.edu]
- Distractibility
Dilation of the TV anulus, adherence of chordal or leaflet tissue to a VSD patch, asynchronous contraction relating to right bundle branch (or more severe degrees) of heart block, arrhythmias, and distraction of papillary muscles through pressure induced [annalspc.com]
Neurologic
- Forgetful
If spontaneous outcome of isolated congenital corrected transposition of great arteries is good, we must not forget severity of associated forms. A regular follow up is necessary [vlibrary.emro.who.int]
Workup
See Workup for more detail. Management Medical care There is little evidence that established medical treatment options for left ventricle dysfunction (ACE inhibitors, beta-blockers, nitrates) produce similar outcomes for systemic right ventricles. [emedicine.medscape.com]
X-Ray
- Mediastinal Mass
Congenitally-corrected transposition of the great vessels (CTGV) may be detected de novo in adulthood and the plain radiographic findings may be ambiguous or they may be mimicked by a mediastinal mass. [ncbi.nlm.nih.gov]
QRS Wave
- Narrow QRS Complex
Spontaneous ventricular tachycardia has also been reported. [9] Supportive pacing is usually not necessary for isolated congenital complete heart block with good ventricular function, especially when the escape rhythm has a narrow QRS complex as in our [joacc.com]
AV BLOCK- More than 75% pts exhibits varying degree of heart blocks from PR prolongation to CHB, even in same pt block varies from time to time CHB associated with narrow QRS complex duration. 27. [slideshare.net]
Blocks
- Third Degree Atrioventricular Block
Since the patient had presented periods of third-degree atrioventricular block and was highly pacing-dependent during follow-up ICD consultations prior to hospitalization, and we wished to use the minimum amount of intravascular prosthetic material, a [elsevier.pt]
Jugular Venous Pressure
- Prominent A-Wave
ECG absence of Q waves in the lateral precordium (V4-6) physiologic Q waves in these leads often referred to as "septal" Q waves prominent Q waves in right precordium (V1-3) third degree atrioventricular (AV) conduction block 9 In this anomaly, the right [radiopaedia.org]
Hypertrophy
- Biventricular Hypertrophy
The electrocardiogram (ECG) at rest showed a normal sinus rhythm with precordial ST- segment depression (V2 to V4), T-wave inversion (V2 to V3) and signs of biventricular hypertrophy. [springerplus.springeropen.com]
Treatment
Treatment Diagnosis and treatment for babies is based on clinical findings (such as weak pulses in the legs) and echocardiography. Typically treatment is surgery, but occasionally heart catheterisation may be the treatment of choice. [evelinalondon.nhs.uk]
Introduction: Improved medical and surgical treatment strategies led to a tremendous increase of the incidence of end-stage heart failure which has almost tripled during the past years. [thieme-connect.com]
If your child has other defects, however, they may develop symptoms because of these and will probably need treatment. Treatment The aim of treatment is to support the heart and protect the lungs from high blood flow if there is a VSD present. [chfed.org.uk]
This is a very different condition to TGA, and although the names are similar (which can cause confusion), the clinical journey and treatment is very different. [heartcentreforchildren.com.au]
الصفحة 24 - Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). الصفحة 134 - Sacks FM, Pfeffer MA, Moye LA et al. [books.google.com]
Prognosis
CONCLUSIONS: The long-term prognosis of the double-switch operation for congenitally corrected transposition of the great arteries was acceptable. [ncbi.nlm.nih.gov]
Treatment [ edit ] Simple l-TGA has a very good prognosis, with many individuals being asymptomatic and not requiring surgical correction. [en.wikipedia.org]
Prognosis Left untreated, this disease is fatal within the first weeks of life. Prevention Because there is no identifiable cause, there is no way to prevent this condition. Resources Books Alexander, R. W., R. C. Schlant, and V. Fuster, editors. [medical-dictionary.thefreedictionary.com]
The absence of associated anomalies portends a good overall prognosis, and diagnosis is delayed until later in life in these patients. [consultant360.com]
Prognosis Patient prognosis depends on AV conduction, arrhythmias, structural abnormalities, and degree of hemodynamic disturbance. [5] Sudden death may be related to the onset of complete heart block or atrial or ventricular arrhythmias. [emedicine.medscape.com]
Etiology
The etiology of the tricuspid valve stenosis and regurgitation was considered rheumatic because of a history of polyarthritis, early presentation, characteristic echocardiographic valve morphology and combined involvement of the tricuspid valve and the [heartviews.org]
The oldest individual previously reported in the literature to have survived with this anomaly was 80 years old. 1 The etiology of heart failure in the 91-year-old patient discussed in our article was tricuspid regurgitation, although congestive heart [consultant360.com]
Atrioventricular septal defects: possible etiologic differences between complete and partial defects. Teratology, 63, 87-93. PMID: 11241431 3.0.CO;2-5 DOI. Reviews Kutty S, Danford DA, Diller GP & Tutarel O. (2018). [embryology.med.unsw.edu.au]
Etiology Causes and exposures associated with congenitally corrected transposition of the great arteries have not been identified clearly. A substantial number of patients with congenital heart disease have a deletion of chromosome band 22q11. [emedicine.medscape.com]
Epidemiology
Epidemiology United States data Data from the Baltimore-Washington Infant Study supported the fact that congenitally corrected transposition is a rare disorder. [4] As many as 40 infants per 100,000 live births are affected by congenitally corrected transposition [emedicine.medscape.com]
Annual Report of Research Committee on Epidemiology of the Intractable Diseases. March 1995. The Ministry of Health and Welfare of Japan, 1995, 137-139 (in Japanese). Watanabe Y et al. [15d-instrument.net]
Pathophysiology
(Click picture to show/hide bloodflows) Pathophysiology The physiology of "corrected" transposition of the great vessels is related to the associated defects. [vhlab.umn.edu]
1243 Percutaneous Coronary Intervention 1258 Percutaneous Cardiac Procedures 1273 Coronary Artery Bypass Surgery 1290 Approaches to the Patient with Prior Bypass Surgery 1306 Percutaneous Valve Dilatations 1316 Global Pandemic of Heart Failure 1330 Pathophysiology [books.google.com]
“Pathophysiology, clinical manifestations, and diagnosis of Dtransposition of the great arteries.” UptoDate Jan 19, 2011. Fulton, David R; Kane, David A. “Management and outcome of D-transposition of the great arteries.” UptoDate Oct 18, 2011. [pedclerk.bsd.uchicago.edu]
Pathophysiology Congenitally corrected transposition of the great vessels is a rare congenital heart defect associated with multiple cardiac morphologic abnormalities and conduction defects. [emedicine.medscape.com]
Prevention
While use of ICDs for secondary prevention is generally accepted, implantation for primary prevention remains a topic of great scrutiny. [innovationsincrm.com]
Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. [books.google.com]
Prevention Because there is no identifiable cause, there is no way to prevent this condition. Resources Books Alexander, R. W., R. C. Schlant, and V. Fuster, editors. The Heart. 9th ed. [medical-dictionary.thefreedictionary.com]
Preventing Endocarditis People who have l-transposition of the great arteries may require endocarditis prophylaxis if they have a prosthetic valve. [heart.org]
Advantages of this over atrial switch are anatomical correction of discordant ventriculoarterial connections, reduced incidence of rhythm disturbances, prevention of the development of right ventricular failure. [4] However, neo-aortic root dilation, [saudija.org]