Truncus arteriosus: Difference between revisions

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'''Truncus arteriosus''' is a rare type of [[congenital heart disease]] that presents at birth. In this condition, a single common blood vessel comes out of the heart, instead of the usual two (the [[aorta]] and the [[pulmonary artery]]).
{{Short description|A rare congenital heart defect}}
{{Use dmy dates|date=October 2023}}


== Symptoms ==
'''Truncus arteriosus''' is a rare type of [[congenital heart defect]] in which a single blood vessel (the truncus arteriosus) comes out of the right and left ventricles, instead of the normal two vessels (the [[pulmonary artery]] and the [[aorta]]). This condition results in a mixture of oxygenated and deoxygenated blood being circulated throughout the body.
The symptoms of truncus arteriosus may vary, but often include [[cyanosis]] (blue skin, lips and nails due to lack of oxygen), poor feeding, excessive sweating, rapid breathing, fatigue and delayed growth and development.


== Causes ==
==Anatomy and Pathophysiology==
Truncus arteriosus occurs during fetal growth when the baby's heart is developing. While the exact cause is unknown, some cases have been associated with specific genetic disorders, such as [[DiGeorge syndrome]] (22q11.2 deletion syndrome).
In a normal heart, the [[pulmonary artery]] and the [[aorta]] are separate, with the pulmonary artery carrying deoxygenated blood from the right ventricle to the lungs, and the aorta carrying oxygenated blood from the left ventricle to the rest of the body. In truncus arteriosus, these two vessels are combined into a single vessel, which then branches into the pulmonary arteries and the aorta.


== Diagnosis ==
[[File:Gray462.png|thumb|Diagram of a normal heart showing the separate pulmonary artery and aorta.]]
Truncus arteriosus is usually diagnosed soon after birth due to the presence of a heart murmur or symptoms of heart failure. Diagnostic tests may include a [[chest X-ray]], [[electrocardiogram]], [[echocardiogram]], or [[cardiac catheterization]].


== Treatment ==
The condition is often associated with a [[ventricular septal defect]] (VSD), which is a hole between the right and left ventricles. This allows blood to mix between the two sides of the heart, leading to reduced oxygen levels in the blood that is pumped to the body.
Treatment for truncus arteriosus is surgical and aims to separate the blood flow to the lungs and the body. This involves closing off the original common blood vessel and creating a new pathway (conduit) for blood to reach the lungs. The conduit is usually replaced as the child grows.


== Prognosis ==
==Types==
With early diagnosis and treatment, the prognosis for children with truncus arteriosus has greatly improved. However, lifelong medical care is often necessary to monitor and manage potential health problems.
Truncus arteriosus is classified into several types based on the anatomy of the pulmonary arteries and their origin from the truncus. The most commonly used classification is the Collett and Edwards classification, which includes:


== See also ==
* '''Type I''': A single pulmonary trunk arises from the truncus arteriosus and then divides into the left and right pulmonary arteries.
* '''Type II''': The left and right pulmonary arteries arise separately but close to each other from the posterior aspect of the truncus.
* '''Type III''': The left and right pulmonary arteries arise separately from the lateral aspects of the truncus.
 
==Diagnosis==
Diagnosis of truncus arteriosus is typically made using [[echocardiography]], which can visualize the single arterial trunk and associated VSD. Other imaging techniques, such as [[cardiac MRI]] or [[CT scan]], may be used to provide additional anatomical details.
 
[[File:Gray469.png|thumb|Diagram showing truncus arteriosus with a single arterial trunk.]]
 
==Treatment==
The treatment for truncus arteriosus is surgical. The goal of surgery is to separate the pulmonary and systemic circulations. This is usually done by closing the VSD and creating a conduit from the right ventricle to the pulmonary arteries. Early surgical intervention is critical to prevent complications such as [[pulmonary hypertension]].
 
==Prognosis==
With advances in surgical techniques, the prognosis for individuals with truncus arteriosus has improved significantly. However, long-term follow-up is necessary to monitor for potential complications, such as conduit obstruction or valve dysfunction.
 
==Related pages==
* [[Congenital heart defect]]
* [[Congenital heart defect]]
* [[Heart surgery]]
* [[Ventricular septal defect]]
* [[Pediatric cardiology]]
* [[Pulmonary artery]]
* [[Aorta]]


== References ==
==References==
<references />
* Hoffman, J.I.E., & Kaplan, S. (2002). The incidence of congenital heart disease. ''Journal of the American College of Cardiology'', 39(12), 1890-1900.
* Van Praagh, R. (2009). The segmental approach to diagnosis in congenital heart disease. ''Pediatric Cardiology'', 30(5), 701-705.
 
[[File:Gray1088.png|thumb|Illustration of the heart showing the truncus arteriosus.]]
[[File:Truncus_arteriosus.jpg|thumb|Clinical image of truncus arteriosus.]]


[[Category:Congenital heart defects]]
[[Category:Congenital heart defects]]
[[Category:Cardiology]]
[[Category:Pediatrics]]
{{stub}}

Revision as of 23:51, 9 February 2025

A rare congenital heart defect



Truncus arteriosus is a rare type of congenital heart defect in which a single blood vessel (the truncus arteriosus) comes out of the right and left ventricles, instead of the normal two vessels (the pulmonary artery and the aorta). This condition results in a mixture of oxygenated and deoxygenated blood being circulated throughout the body.

Anatomy and Pathophysiology

In a normal heart, the pulmonary artery and the aorta are separate, with the pulmonary artery carrying deoxygenated blood from the right ventricle to the lungs, and the aorta carrying oxygenated blood from the left ventricle to the rest of the body. In truncus arteriosus, these two vessels are combined into a single vessel, which then branches into the pulmonary arteries and the aorta.

Diagram of a normal heart showing the separate pulmonary artery and aorta.

The condition is often associated with a ventricular septal defect (VSD), which is a hole between the right and left ventricles. This allows blood to mix between the two sides of the heart, leading to reduced oxygen levels in the blood that is pumped to the body.

Types

Truncus arteriosus is classified into several types based on the anatomy of the pulmonary arteries and their origin from the truncus. The most commonly used classification is the Collett and Edwards classification, which includes:

  • Type I: A single pulmonary trunk arises from the truncus arteriosus and then divides into the left and right pulmonary arteries.
  • Type II: The left and right pulmonary arteries arise separately but close to each other from the posterior aspect of the truncus.
  • Type III: The left and right pulmonary arteries arise separately from the lateral aspects of the truncus.

Diagnosis

Diagnosis of truncus arteriosus is typically made using echocardiography, which can visualize the single arterial trunk and associated VSD. Other imaging techniques, such as cardiac MRI or CT scan, may be used to provide additional anatomical details.

Diagram showing truncus arteriosus with a single arterial trunk.

Treatment

The treatment for truncus arteriosus is surgical. The goal of surgery is to separate the pulmonary and systemic circulations. This is usually done by closing the VSD and creating a conduit from the right ventricle to the pulmonary arteries. Early surgical intervention is critical to prevent complications such as pulmonary hypertension.

Prognosis

With advances in surgical techniques, the prognosis for individuals with truncus arteriosus has improved significantly. However, long-term follow-up is necessary to monitor for potential complications, such as conduit obstruction or valve dysfunction.

Related pages

References

  • Hoffman, J.I.E., & Kaplan, S. (2002). The incidence of congenital heart disease. Journal of the American College of Cardiology, 39(12), 1890-1900.
  • Van Praagh, R. (2009). The segmental approach to diagnosis in congenital heart disease. Pediatric Cardiology, 30(5), 701-705.
Illustration of the heart showing the truncus arteriosus.
Clinical image of truncus arteriosus.