00:00 / 00:00
Bundle branch block
Pulseless electrical activity
Atrioventricular nodal reentrant tachycardia (AVNRT)
Premature atrial contraction
Long QT syndrome and Torsade de pointes
Premature ventricular contraction
Rheumatic heart disease
Atrial septal defect
Coarctation of the aorta
Patent ductus arteriosus
Ventricular septal defect
Hypoplastic left heart syndrome
Tetralogy of Fallot
Total anomalous pulmonary venous return
Transposition of the great vessels
Pericarditis and pericardial effusion
Aortic valve disease
Mitral valve disease
Pulmonary valve disease
Tricuspid valve disease
Coronary steal syndrome
Polycystic kidney disease
Renal artery stenosis
Peripheral artery disease
Subclavian steal syndrome
Superior mesenteric artery syndrome
Human herpesvirus 8 (Kaposi sarcoma)
Chronic venous insufficiency
Deep vein thrombosis
Acyanotic congenital heart defects: Pathology review
Aortic dissections and aneurysms: Pathology review
Atherosclerosis and arteriosclerosis: Pathology review
Cardiac and vascular tumors: Pathology review
Cardiomyopathies: Pathology review
Coronary artery disease: Pathology review
Cyanotic congenital heart defects: Pathology review
Dyslipidemias: Pathology review
Endocarditis: Pathology review
Heart blocks: Pathology review
Heart failure: Pathology review
Hypertension: Pathology review
Pericardial disease: Pathology review
Peripheral artery disease: Pathology review
Shock: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Vasculitis: Pathology review
Ventricular arrhythmias: Pathology review
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Persistent Truncus Arteriosus
20q10 syndromes p. 304
cyanosis with p. 733
embryologic development p. 284
thymic aplasia p. 114
The truncus arteriosus is a big structure that’s present during fetal development; later in development, it divides to form two separate arteries: the aorta and pulmonary artery. Once it’s fully developed, the aorta comes from the left ventricle, and the pulmonary artery comes from the right ventricle.
A persistent truncus arteriosus describes when this developmental structure doesn’t divide into the two separate arteries. Instead, the baby’s left with one giant artery that branches off from both the right and the left ventricles that then splits off into the aorta and the pulmonary artery. Sometimes, this condition is simply referred to as truncus arteriosus, or TA. The cause of TA is unknown; however, a lot of cases seem to be associated with 22q11.2 deletion syndrome, also known as DiGeorge Syndrome.
Let’s switch to a more simplified view of the heart. All right, so usually deoxygenated blood comes in from the body and travels to the right atrium; then, it goes to the right ventricle and is pumped through the pulmonary artery to the lungs to be re-oxygenated. Next, freshly oxygenated blood passes from the lungs to the left atrium, goes to the left ventricle, and gets pumped through the aorta to the body. Then that circuit repeats, right?
If these two great arteries, the aorta and the pulmonary artery, don’t divide, you essentially have this massive artery coming from both ventricles. However, notice that this one big artery does eventually split into the aorta and pulmonary artery. Even though they eventually split off, before they do, it’s just one single vessel; thus, the oxygenated and deoxygenated blood mix. When deoxygenated blood mixes into the systemic circulation, it’ll often present as cyanosis, a bluish-purple discoloration of the skin, which can be seen in a baby within the first days after birth.
Persistent truncus arteriosus (PTA) is a rare congenital heart defect in which the embryonic structure that normally divides into the pulmonary artery and aorta fails to form properly, resulting in a single large vessel that supplies blood to both the systemic and pulmonary circulations.
Symptoms of PTA may include cyanosis, rapid breathing, poor feeding, and difficulty gaining weight. If left untreated, PTA can lead to heart failure and other complications. Treatment typically involves surgical repair of the defect, which involves separating the pulmonary artery from the aorta and creating a connection between the right ventricle and the pulmonary artery.
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