Basic diagnosis is Down's syndrome. As a newborn this child had a total AVSD that could not be corrected because of abnormally attached papillary muscles. An obvious Eisenmengerþs cyanosis has developed, but without the symptoms of heart failure. First-degree systolic murmur is present and the second heart sound is enhanced. Two separate clicks can be seen on the phonogram, apparently originating from the tricuspid and mitral valves. The second heart sound is hardly split at all and the pulmonary component is very strong because of the elevated pulmonary circulation pressure. Echocardiography shows only a minor shunt in the valves between the atria and the ventricles which is why the spectrogram does not show clear shunt sounds. Age 19.0 years, height 145.0 cm, weight 53.0 kg. Area of auscultation: left fourth ic (LIC4).
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"AVSD and Eisenmenger Syndrome - Image." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/454764/all/AVSD_and_Eisenmenger_syndrome___Image.
AVSD and Eisenmenger syndrome - Image. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/454764/all/AVSD_and_Eisenmenger_syndrome___Image. Accessed April 6, 2020.
AVSD and Eisenmenger syndrome - Image. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. Retrieved April 06, 2020, from https://evidence.unboundmedicine.com/evidence/view/EBMG/454764/all/AVSD_and_Eisenmenger_syndrome___Image
AVSD and Eisenmenger Syndrome - Image [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2020 April 06]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/454764/all/AVSD_and_Eisenmenger_syndrome___Image.
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