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Pulmonary atresia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Overview

Physical Examination

Physical Examination

Pulmonary Atresia With Intact Ventricular Septum:

Central cyanosis is present

Heart

Palpation

Left ventricular impulse is prominent at cardiac apex
Thrill may be present in case of severe tricuspid regurgitation

Auscultation

Heart Sounds

First and second heart sound (S1, S2) are single

Murmurs

A holosystolic murmur indicating tricuspid regurgitation best heard at the left lower sternal border may be present
In severe tricuspid regurgitation, a diastolic rumble may be present
A systolic ejection murmur best heard at the left second or third intercostal space indicating the patent ductus arteriosus may be present.

Pulmonary Atresia With Ventricular Septum defect

Heart

Central cyanosis is present
“A wave” is prominent in a JVP

Palpation

PMI is most prominent at the left lower sternal border

Auscultation

Heart Sounds

First heart sound (S1) is normal
Second heart sound (S2) is loud and single

Murmurs

Systolic murmur best heard at the lower left sternal border is present
In presence of patent ductus arteriosus a continuous murmur may be present
In presence of aortic regurgitation, an early diastolic murmur is present

References

References

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