Resumen
Definição
História e exame físico
Principais fatores diagnósticos
- sopro sistólico de ejeção
- desdobramento fixo da segunda bulha cardíaca
Outros fatores diagnósticos
- presença de fatores de risco
- sopro mesodiastólico
- insuficiência cardíaca congestiva
- deficit no crescimento
- sintomas de arritmias atriais
- cianose
- baqueteamento digital
Fatores de risco
- sexo feminino
- consumo materno de bebidas alcoólicas
- história familiar positiva
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- ecocardiograma
- eletrocardiograma (ECG)
- radiografia torácica
Investigações a serem consideradas
- oximetria de pulso
- tomografia computadorizada (TC)/ressonância nuclear magnética (RNM) do tórax
- cateterismo cardíaco
Algoritmo de tratamento
resistência vascular pulmonar (RVP) <5 unidades Wood (WU) e Qp:Qs <1.5
RVP <5 WU e Qp:Qs ≥1.5, ou evidências de aumento atrial direito
RVP ≥5 WU
Colaboradores
Autores
Christoph Haller, MD
Staff Cardiovascular Surgeon
Division of Cardiovascular Surgery
Labatt Family Heart Centre
The Hospital for Sick Children
Assistant Professor
University of Toronto
Toronto
Canada
Disclosures
CH declares that he has no competing interests.
Acknowledgements
Dr Christoph Haller would like to gratefully acknowledge Dr Sachin Khambadkone, Dr Brandon Lane Phillips, Dr Frank Cetta, and Dr David J. Driscoll, previous contributors of this topic.
Disclosures
SK, BLP, FC, and DJD declare that they have no competing interests.
Peer reviewers
Chawki Elzein, MD
Professor of Surgery
University of Illinois at Chicago
Advocate Children's Hospital
Chicago
IL
Disclosures
CE declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Jone PN, Ivy DD, Hauck A, et al. Pulmonary hypertension in congenital heart disease: a scientific statement from the American Heart Association. Circ Heart Fail. 2023 Jul;16(7):e00080.Full text Abstract
Baumgartner H, De Backer J, Babu-Narayan SV, et al; ESC Scientific Document Group. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J. 2021 Feb 11;42(6):563-645.Full text Abstract
Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2019 Apr 2;139(14):e698-800.Full text Abstract
Abrahamyan L, Dharma C, Alnasser S, et al. Long-term outcomes after atrial septal defect transcatheter closure by age and against population controls. JACC Cardiovasc Interv. 2021 Mar 8;14(5):566-75.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Drenagem venosa pulmonar anômala parcial
- Defeito do septo ventricular
- Persistência do canal arterial
More DifferentialsGuidelines
- ACR Appropriateness Criteria® congenital or acquired heart disease
- 2023 ESC guidelines for the management of infective endocarditis
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer