Summary
Definition
History and exam
Key diagnostic factors
- systolic ejection murmur
- fixed splitting of the second heart sound
Other diagnostic factors
- mid-diastolic murmur
- congestive cardiac failure
- failure to thrive
- symptoms of atrial arrhythmias
- cyanosis
- finger clubbing
Risk factors
- female gender
- maternal alcohol consumption
- positive FHx
Diagnostic investigations
1st investigations to order
- echocardiogram
- ECG
- chest x-ray
Investigations to consider
- chest CT/MRI
- cardiac catheterization
Treatment algorithm
left-to-right shunt
right-to-left shunt
Contributors
Authors
Sachin Khambadkone, MD, DCH, DNB
Consultant in Paediatric and Adolescent Cardiology
Interventional Cardiologist
Honorary Senior Lecturer
Paediatric and Adolescent Cardiology
Great Ormond Street Hospital and Institute of Child Health
London
UK
Disclosures
SK declares that he has no competing interests.
Acknowledgements
Dr Sachin Khambadkone would like to gratefully acknowledge Dr Brandon Lane Phillips, Dr Frank Cetta, and Dr David J. Driscoll, previous contributors of this monograph. BLP, FC, and DJD declare that they have no competing interests.
Peer reviewers
Alexander Opotowsky, MD, MPH
Senior Fellow
Adult Congenital Heart Disease and Pulmonary Hypertension
Department of Cardiology
Children's Hospital Boston
Department of Medicine
Division of Cardiology
Brigham and Women's Hospital
Boston
MA
Disclosures
AO declares that he has no competing interests.
Gianluca Rigatelli, MD, FACP, FACC, FESC, FSCAI
Director
Section of Transcatheter Treatment of Congenital Heart Disease in the Adult
Rovigo General Hospital
Rovigo
Italy
Disclosures
GR declares that he has no competing interests.
Differentials
- Partial anomalous pulmonary venous drainage
- Ventricular septal defect
- Patent ductus arteriosus
More DifferentialsGuidelines
- Advances in managing transition to adulthood for adolescents with congenital heart disease
- ACC/AHA 2008 guidelines for the management of adults with congenital heart disease
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