Transposition of the great arteries - Revision history

Danbot: Add MedicationDose entry for PGE1

2026-03-20T21:21:24Z

Add MedicationDose entry for PGE1

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 ==Disposition==
 *Admit
 ==See Also==

Rossdonaldson1: /* Evaluation */

2024-11-13T16:38:24Z

Evaluation

← Older revision		Revision as of 16:38, 13 November 2024
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	[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]		[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]
	[[File:Transposition great arteries Orphanet 1750-1172-3-27-2.jpg\|thumb\|Subcostal echo view showing discordant ventriculoarterial connections together with the presence of parallel, rather than crossing, great arteries arising from the ventricles.]]		[[File:Transposition great arteries Orphanet 1750-1172-3-27-2.jpg\|thumb\|Subcostal echo view showing discordant ventriculoarterial connections together with the presence of parallel, rather than crossing, great arteries arising from the ventricles.]]
			[[File:Transposition great arteries Orphanet 1750-1172-3-27-1.jpg\|thumb\|Echocardiogram in transposition of the great arteries. This subcostal view shows the left ventricle giving rise to a vessel that bifurcates, which is thus identified as the pulmonary artery.
			Abbreviations: RA=right atrium, RV=right ventricle, LV=left ventricle, PT=pulmonary trunk, LPA and RPA=left and right pulmonary artery.]]
	*[[Echocardiography]]		*[[Echocardiography]]
	*[[ECG]]		*[[ECG]]

Rossdonaldson1: /* Evaluation */

2024-11-13T16:36:30Z

Evaluation

← Older revision		Revision as of 16:36, 13 November 2024
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	==Evaluation==		==Evaluation==
	[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]		[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]
			[[File:Transposition great arteries Orphanet 1750-1172-3-27-2.jpg\|thumb\|Subcostal echo view showing discordant ventriculoarterial connections together with the presence of parallel, rather than crossing, great arteries arising from the ventricles.]]
	*[[Echocardiography]]		*[[Echocardiography]]
	*[[ECG]]		*[[ECG]]

Rossdonaldson1: /* Background */

2021-10-23T12:21:24Z

Background

← Older revision		Revision as of 12:21, 23 October 2021
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	==Background==		==Background==
			[[File:D-tga-575px.jpg\|thumb\|Dextro-transposition of the great arteries.]]
	[[File:D-TGA.jpg\|thumb\|]]		[[File:D-TGA.jpg\|thumb\|]]
	*Type of cyanotic [[congenital heart disease]]		*Type of cyanotic [[congenital heart disease]]

ClaireLewis at 18:33, 26 September 2019

2019-09-26T18:33:26Z

← Older revision		Revision as of 18:33, 26 September 2019
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	**Left ventricular outflow tract obstruction (dynamic or anatomical)		**Left ventricular outflow tract obstruction (dynamic or anatomical)
	**Mitral and tricuspid valve abnormalities		**Mitral and tricuspid valve abnormalities
	**Coronary artery variations		**[[coronary artery anomalies\|Coronary artery variations]]
	*Prevalence in the United States is estimated to be 4.7 per 10,000 live births<ref>Improved national prevalence estimates for 18 selected major birth defects--United States, 1999-2001. MMWR Morb Mortal Wkly Rep. 2006;54(51):1301-5.</ref>		*Prevalence in the United States is estimated to be 4.7 per 10,000 live births<ref>Improved national prevalence estimates for 18 selected major birth defects--United States, 1999-2001. MMWR Morb Mortal Wkly Rep. 2006;54(51):1301-5.</ref>
	*Accounts for 3% of all [[congenital heart disease]] and almost 20% of all cyanotic CHD defects <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>		*Accounts for 3% of all [[congenital heart disease]] and almost 20% of all cyanotic CHD defects <ref>Reller MD. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153(6):807-13.</ref>
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	==Clinical Features==		==Clinical Features==
	*Cyanosis, determined by amount of intercirculatory mixing		*Cyanosis, determined by amount of intercirculatory mixing
	*[[Tachypnea]]		*[[shortness of breath (peds)\|Tachypnea]]
	*[[Murmur]]s		*[[Murmur]]s
	**Pansystolic murmur at lower left sternal border if there is a VSD		**Pansystolic murmur at lower left sternal border if there is a VSD
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	==Evaluation==		==Evaluation==
	[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]		[[File:Transposition-of-great-vessels.jpg\|thumb\|"Egg on side/string" sign]]
	*Echocardiography		*[[Echocardiography]]
	*[[ECG]]		*[[ECG]]
	**Initial ECG often normal		**Initial ECG often normal

ClaireLewis: /* Clinical Features */

2019-08-18T16:49:19Z

Clinical Features

← Older revision		Revision as of 16:49, 18 August 2019
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	**Pansystolic murmur at lower left sternal border if there is a VSD		**Pansystolic murmur at lower left sternal border if there is a VSD
	**Systolic ejection murmur along the upper left sternal border in patients with left ventricular outflow obstruction		**Systolic ejection murmur along the upper left sternal border in patients with left ventricular outflow obstruction
	*Diminished pulses in patients who also have coarctation of the aorta or interruption of the aortic arch		*Diminished pulses in patients who also have [[coarctation of the aorta]] or interruption of the aortic arch

	==Differential Diagnosis==		==Differential Diagnosis==

Mholtz at 00:42, 25 February 2019

2019-02-25T00:42:33Z

← Older revision		Revision as of 00:42, 25 February 2019
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	**The second sends oxygenated pulmonary venous blood to the left atrium and back to the lungs via the left ventricle and pulmonary artery		**The second sends oxygenated pulmonary venous blood to the left atrium and back to the lungs via the left ventricle and pulmonary artery
	*Incompatible with life unless there is communication between the two parallel circuits		*Incompatible with life unless there is communication between the two parallel circuits
	**Mixing occurs either intracardiac (patent foramen ovale, [[VSD]] or [[ASD]]),		**Mixing occurs either intracardiac (patent foramen ovale, [[VSD]] or [[ASD]]) '''OR''' extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)
	**Or via extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)
	*Often associated with other cardiac abnormalities		*Often associated with other cardiac abnormalities
	**[[Ventricular septal defect]]s (VSD)		**[[Ventricular septal defect]]s (VSD)

SLuckettG: /* Management */

2019-02-24T14:47:59Z

Management

← Older revision		Revision as of 14:47, 24 February 2019
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	**Balloon is placed across the atrial septum into the left atrium, inflated and then pulled vigorously back across the septum to produce an [[ASD]]		**Balloon is placed across the atrial septum into the left atrium, inflated and then pulled vigorously back across the septum to produce an [[ASD]]
	*Surgery, Arterial switch operation		*Surgery, Arterial switch operation
			**In rare instances, atrial switch operation when coronary artery anatomy makes arterial switch infeasible
	**Typically performed within the first two weeks of life		**Typically performed within the first two weeks of life
	*Most will die within the first year of life without treatment		*Most will die within the first year of life without treatment

SLuckettG: /* Background */

2019-02-24T14:45:10Z

Background

← Older revision		Revision as of 14:45, 24 February 2019
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	*Incompatible with life unless there is communication between the two parallel circuits		*Incompatible with life unless there is communication between the two parallel circuits
	**Mixing occurs either intracardiac (patent foramen ovale, [[VSD]] or [[ASD]]),		**Mixing occurs either intracardiac (patent foramen ovale, [[VSD]] or [[ASD]]),
	**or via extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)		**Or via extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)
	*Often associated with other cardiac abnormalities		*Often associated with other cardiac abnormalities
	**[[Ventricular septal defect]]s (VSD)		**[[Ventricular septal defect]]s (VSD)

ClaireLewis at 19:33, 27 January 2019

2019-01-27T19:33:53Z

← Older revision		Revision as of 19:33, 27 January 2019
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	**or via extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)		**or via extracardiac connections ([[patent ductus arteriosus]] or bronchopulmonary collateral circulation)
	*Often associated with other cardiac abnormalities		*Often associated with other cardiac abnormalities
	**Ventricular septal ~~defects~~ (VSD)		**[[Ventricular septal defect]]s (VSD)
	**Left ventricular outflow tract obstruction (dynamic or anatomical)		**Left ventricular outflow tract obstruction (dynamic or anatomical)
	**Mitral and tricuspid valve abnormalities		**Mitral and tricuspid valve abnormalities
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	==Clinical Features==		==Clinical Features==
	*Cyanosis, determined by amount of intercirculatory mixing		*Cyanosis, determined by amount of intercirculatory mixing
	*Tachypnea		*[[Tachypnea]]
	*~~Murmurs~~		*[[Murmur]]s
	**Pansystolic murmur at lower left sternal border if there is a VSD		**Pansystolic murmur at lower left sternal border if there is a VSD
	**Systolic ejection murmur along the upper left sternal border in patients with left ventricular outflow obstruction		**Systolic ejection murmur along the upper left sternal border in patients with left ventricular outflow obstruction
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	*[[ECG]]		*[[ECG]]
	**Initial ECG often normal		**Initial ECG often normal
	*~~Chest xray~~		*[[CXR]]
	**Classically with “egg on a string” appearance, thought to be a result of the great arteries forming a narrowed vascular pedicle when transposed		**Classically with “egg on a string” appearance, thought to be a result of the great arteries forming a narrowed vascular pedicle when transposed
	*Cardiac ~~catherization~~		*Cardiac catheterization
	**Remains the gold standard, but seldom required to make the diagnosis		**Remains the gold standard, but seldom required to make the diagnosis