By Donald N. Ross B. Sc., M. B., CH. B., F. R. C. S. (auth.)
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Additional info for A Surgeons’ Guide to Cardiac Diagnosis: Part II The Clinical Picture
Lateral angiocardiogram in transposition Fig. 12 Differential Diagnosis This has been discussed under Fallot's tetralogy (p. 8) and includes all forms of cyanotic heart disease. Indications for Operation Cases of transposition live precarious lives, being dependent upon the mixture of arterial and venous blood across abnormal intra or extracardiac communications. In the severely disabled new-born child with transposition, operation represents the only chance of survival. Principles of Treatment This aims at increasing the mixing of arterial and venOUS blood, or may be directed at correction of the abnormal circulation.
Frequently a patent foramen ovale or a secundum atrial septal defect is present with resulting cyanosis. Symptomatology Patients complain of dyspnoea and fatigue and are liable to attacks of paroxysmal tachycardia. There may be cyanosis, clubbing and polycythaemia although the patients may present as an acyanotic problem. The cardiac output is low as a result of inadequate right ventricular function. The arterial pulse is small and peripheral cyanosis may be present. The venous pressure is normal unless there is hea,rt failure from tachycardia.
15). Where the right or left ventricle is obstructed it is important for the clinician to be able to assess which ventricle carries the obstructive burden and its severity. Pulmonary Stenosis 29 Pulmonary Stenosis Definition This is a condition of obstruction to the flow of blood from the right ventricle in association with a normal (or intact) ventricular septum. It is sometimes known as pulmonary stenosis with a normal aortic root, but it is more important to emphasise the absence of a ventricular septal defect.
A Surgeons’ Guide to Cardiac Diagnosis: Part II The Clinical Picture by Donald N. Ross B. Sc., M. B., CH. B., F. R. C. S. (auth.)