clinical presentation

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Symptoms are variable, with a spectrum from pink with normal heart size to profound central cyanosis.

Signs include:

  • clubbing and cyanosis, usually progressive with age.
  • pulse - can present with supraventricular tachycardias
  • jugular venous pressure - an atrial defect if present decompresses the atrium; if absent tricuspid regurgitation causes mild elevation of venous pressure and a systolic wave.
  • auscultation - There is a split first heart sound - loud delayed tricuspid closure - split second heart sound - delayed P2 due to right bundle branch block. Often there is a tricuspid opening snap, a short ventricular filling murmur and an atrial (fourth) sound. If there is significant tricuspid regurgitation there is a prominent pansystolic murmur at the left sternal edge.

Last reviewed 01/2018