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Transposition of the great arteries (clinical manifestations (Severe…
Transposition of the great arteries
definition
Transposition of the great arteries occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent, parallel pulmonary and systemic circulations; oxygenated blood cannot reach the body except through openings connecting the right and left sides.
Pathophysiology
Systemic and pulmonary circulations are completely separated in transposition of the great arteries. After returning to the right heart, desaturated systemic venous blood is pumped into the systemic circulation without being oxygenated in the lungs; oxygenated blood entering the left heart goes back to the lungs rather than to the rest of the body. This anomaly is not compatible with life unless desaturated and oxygenated blood can mix through openings at one or more levels (eg, atrial, ventricular, or great artery level).
clinical manifestations
Severe cyanosis occurs within hours of birth
Dyspnea,
Tachycardia
Inability to gain weight
Large ventricular septal defect
Diagnosis
Chest x-ray and ECG
Echocardiography
Cardiac catheterization
Nursing interventions
Initially, must be placed on oxygen, and possibly even on a ventilator, to assist his or her breathing.
patient must in bed rest
Administration of medication as prescribed
Causes
The heart forms during the first 8 weeks of fetal development. The problem occurs in the middle of this time, allowing the aorta and pulmonary artery to become attached to the incorrect chamber.
Some congenital heart defects may have a genetic link causing heart problems to occur more often in certain families. Most of the time this heart defect occurs by chance, with no clear reason for its development