The tricuspid valve shifts down the deformity and has clinical manifestation and diagnoses _'s symptom

The tricuspid valve shifts down the deformity and has clinical manifestation and diagnoses _'s symptom
The tricuspid valve shifts down the deformity to have clinical manifestation and diagnose
(1) Symptom: A few patients can present dyspnea, cyanosis and congestive and in heart failure in one week after born in. But most patient enter childhood out of breath weak, palpitation, cyanosis and in heart failure appear tired gradually after the issue. Each age group patient can present sex tachycardia on the room, some patients surge syndrome in advance.
(2) Physical sign: Most patients grow and are lack of, physical and modest, the flush similar bicuspid valve face of cheek of cheekbones of about 1/3 of the patients, often have cyanosis at various degrees. The intersection of case and left brisket of cardiac dilatation rise, heart the intersection of voiced sound and circle expand, brestbone left reason can lay one's hand on, get the intersection of tricuspid valve and systolic phase produced all to close tremble. Underpart and apex of the heart district of apex of the heart district beat normally or weaken. Because atrium dextrum and room right ventricle are highly expanded, the neck vein can not beat obviously. The intersection of heart and auscultation, heart sound light, brestbone left reason can hear tricuspid valve close the intersection of systolic phase and noise that does not produce all, can also hear the relaxation period noise that tricuspid stenosis produces sometimes, the miscellaneous stereo degree is strengthened while inhaling. Delay closing because of the tricuspid valve frontal lobe increasing, the 1st sound is split, and the compositions of delaying appearing are strengthened. The second heart sound split often also and lung artery petal shut off transliteration to be lighter, some cases can present galloping horse's law. The belly may lay one's hand on to the swelling liver but seldom present the liver to beat while checking. Patient cyanosis can point the poke while being getting serious childhood ' Toe) .
(3) Auxiliary examination
( 1) X-ray examination behaves: The typical case can be seen the atrium dextrum and increase and flow out one and move the upward foreign side with the right ventricle, become narrow to have mediastinally, the blood vessel lamination of lung is normal or reduces. There can not be unusual signs in a few case heart shadows.
( 2) Check in electrocardiogram: The model is shown as the atrium dextrum is loose, P wave is high and sharp, prop up block in incompleteness or complete right bunch. The right of electric axle leans towards, the chest becomes low to unite R wave voltage to lead, P-R interval lengthened, often has disorderly rhythm of the heart of the sex on rooms, about 5% of the patients reveal the B type surge syndrome in advance.
( 3) Tangent plane ultrasonic heart cardon and Doppler are checked: Reveal a leaf increased before the tricuspid valve, the activity is large in range. It separate petals of leaf and after shift down obviously petals of leaf,there are bad on development, there are poor in degree on activity. The tricuspid valve closes the delay, the position of valve moves to left, interventricular septum movements are abnormal. Atrium dextrum and room right ventricle reveal enormous atrium dextrum together, it is shortened directly that functional right ventricle is vertical. Doppler can reveal the atrium shunts left and returns to flowing with the tricuspid valve in horizontal right while checking.
( 4) Right heart conduit and alternative radiography: The atrium dextrum is enormous, the pressure increases, the curve a waves of pressure and V waves are tall and big. The room right ventricle presents the room curve of pressure, the electric picture of a of heart is a right ventricle type, and the heart conduit of person who has atrial septal defect of heart can enter the atrium sinistrum from the atrium dextrum. Atrium level can appear right go to left, shunt, right ventricle systolic pressure normal relaxation pigeonhole, rise at the end, some cases can measure the tricuspid valve and step one and press difference. The radiography of right heart reveals the atrium dextrum obviously expands and occupies the position of left ventricle, the function right ventricle lies in the right room to flow out one. Valve mouth move to the intersection of backbone and left reason, right ventricle bottom flange can reveal tricuspid valve petals of ring cut mark and room ventricle and the intersection of function and another one among the ventricle cut the mark. The lung artery is always done and the branch is tiny, the atrium level has right that is going to the person who shunts left then the atrium sinistrum is developed ahead of time.
There are a lot of without being changed for difference on pathology on it is odd-shaped in Ebstein,pathological changes basic is for tricuspid valve petals of leaf and right ventricle abnormal development and with diaphragm petals of leaf and behind there shift down is petals of leaf, adhere to the right ventricle wall of the lower side of a ring of tricuspid valve through the papilla skin of chorde tendinae. A leaf of tricuspid valve increases or shrinks, often increase thick deformation to shorten. It involve most often pathological change on diaphragm petals of leaf,take second place petals of leaf, diaphragm petals of leaf after being and behind can lack petals of leaf partly. It is rare for a leaf person before pathological change is involved. A leaf originated from a ring of normal tricuspid valve ago, could increase like the sail, there can be a lot of apertures sometimes, adhere to with chorde tendinae and papilla skin of the hypoplasia the ventricle wall through shortening. A leaf shifted down makes the right ventricle divided into two components, the extended ventricle is called the room ventricle above a leaf, its function is similar to atrium dextrum; Under a leaf is a function right ventricle. The atrium dextrum is expanded, the wall fiber increases thick in the room. Atrium dextrum and height expand thin room of wall right ventricle link first loud heart, play a role in storing up the blood, and the function right ventricle of a leaf lower side arises to arrange the function of the liquid of bleeding.
The tricuspid valve shifts down the case because of the tricuspid valve a ring and right ventricle is highly expanded and a leaf deformity can not be often closed completely. If petals of the intersection of leaf and free the intersection of reason and component glue, increase petals of leaf can lead to the fact blood flow obstruct, produce tricuspid stenosis at various degrees between room ventricle and function right ventricle ago. Form by the intersection of room and room and room room bunch dissect position to be normal, the intersection of right and bunch prop up, might increase membrane oppress produce Right deviation bunch, prop up block in the thick heart, about 5% of the cases have unusual Kent to conduct bunch and surge syndrome in advance. The tricuspid valve shifts down about 50- 60% in the case with oval hole not closing or heart atrial septal defect, atrium level appear right go to left, shunt, arterial oxygen saturation reduce, present cyanosis on being clinical. Other amalgamation deformity still have lung narrow arteries, ventricular septal defect, artery conduit not closing, block of four, misplacing, narrow and inborn mitral stenosis of contracting of aorta of main artery that the law has been happy,etc..
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