II. History

  1. First described by German physician in 1897

III. Pathophysiology

  1. Complication of untreated Ventricular Septal Defect
  2. Findings
    1. Ventricular Septal Defect
    2. Pulmonary Hypertension
    3. Right to left shunt
    4. Overriding aorta variably present

IV. Symptoms

V. Signs

  1. Cyanosis
  2. Systolic Murmur in the 4th left intercostal interspace
  3. Accentuated P2 of the Second Heart Sound
  4. Finger Clubbing
  5. Accentuated precordial thrust of right ventricle

VI. Diagnostics: Electrocardiogram

  1. Right Axis Deviation
  2. Ventricular Hypertrophy

VII. Labs

  1. Hemoglobin increased (Erythrocytosis)

IX. References

  1. Saenz (1999) Am Fam Physician 59(7):1857-66 [PubMed]
  2. Cyran (1998) PREP review lecture, October, Phoenix
  3. Merenstein (1994) Pediatrics, Lange

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