How to differentiate between congenital Cyanotic Heart Diseases

[angleoflouise]

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This is a weak topic of mine. There are three of them that seem the same to me and very hard to differentiate in the question stem. I am looking at BP Pediatrics and all three (truncus arteriosus, TAPVC, and transposition of the great arteries) have : A single loud S2, Cardiomegaly, and increased pulmonary vascular markings!!

My question is, how do you differentiate between the three? Has anyone found buzz words or something for the three?

thanks!🙂

PS I know there is five, but I have found a way to differentiage TOF and Tricuspid Atresia.

truncus arteriosus - di george, vsd always, loud ejection click, single s2, biventricular hypertrophy, increased pulmonary vascular markings, cardiomegaly.
TGA - cyanosis present from virth, increased pulmonary vascular markings, loud single s2, "egg shaped silouette"
TAPVR - chf, wide and fixed split s2, loud p2, increased pulmonary vascular markings, cardiomegaly, RVH.
Tricuspid Atresia - easy, decreased pulmonary vascular markings, no cardiomegaly, increased size of Right Atrium
TOF - tet spells, etc....

 

[OveractiveBrain]

This is a weak topic of mine. There are three of them that seem the same to me and very hard to differentiate in the question stem. I am looking at BP Pediatrics and all three (truncus arteriosus, TAPVC, and transposition of the great arteries) have : A single loud S2, Cardiomegaly, and increased pulmonary vascular markings!!

My question is, how do you differentiate between the three? Has anyone found buzz words or something for the three?

thanks!🙂

PS I know there is five, but I have found a way to differentiage TOF and Tricuspid Atresia.

truncus arteriosus - di george, vsd always, loud ejection click, single s2, biventricular hypertrophy, increased pulmonary vascular markings, cardiomegaly.
TGA - cyanosis present from virth, increased pulmonary vascular markings, loud single s2, "egg shaped silouette"
TAPVR - chf, wide and fixed split s2, loud p2, increased pulmonary vascular markings, cardiomegaly, RVH.
Tricuspid Atresia - easy, decreased pulmonary vascular markings, no cardiomegaly, increased size of Right Atrium
TOF - tet spells, etc....

Here's the cool thing a bout step 2. Its usually whats the next step? If you see a murmur, get an Echo. I know I'm not answering the question you asked, but it seems like you already covered this topic pretty well. its like beating a dead horse with another dead horse.

Step 2 exam: Peditric Murmur? Get echo. then... Patent Ductus (Endomethicin, PGE), VSD (wait, or surgery by age 1), then Surgery for just about everything

P.S. I've never seen a question other than for Truncus Arteriosus or TOF (risk factors and management)

 

[angleoflouise]

Here's the cool thing a bout step 2. Its usually whats the next step? If you see a murmur, get an Echo. I know I'm not answering the question you asked, but it seems like you already covered this topic pretty well. its like beating a dead horse with another dead horse.

Step 2 exam: Peditric Murmur? Get echo. then... Patent Ductus (Endomethicin, PGE), VSD (wait, or surgery by age 1), then Surgery for just about everything

P.S. I've never seen a question other than for Truncus Arteriosus or TOF (risk factors and management)

I hear what you are saying, but I have missed some questions on qbanks that ask what is the anomaly that the kid has and they give you a murmur and cyanosis, and "egg shaped sillhouette" and ask you to identify the anomaly. But, thanks for the reply!! 🙂 No one wants to dive into this cyanotic heart mess with me.

 

[OveractiveBrain]

I hear what you are saying, but I have missed some questions on qbanks that ask what is the anomaly that the kid has and they give you a murmur and cyanosis, and "egg shaped sillhouette" and ask you to identify the anomaly. But, thanks for the reply!! 🙂 No one wants to dive into this cyanotic heart mess with me.

I guess you "learned" from that question... I wouldn't sweat it.

 

[Valadi]

Hey, this annoys me all the time. Here's what I know:

Tetralogy - Single S2, WITH A SYSTOLIC MURMUR, and the usual stuff.
TGA - Single S2, no murmur
Tricuspid Atresia - Single S2, SYSTOLIC MURMUR, Left axis deviation.

Forget the vascular markings thing because it's only always consistently elevated for Transposition. For the rest, it depends on the degree of malformation.

The rest are as you said.

Good luck!