pediatrics
Persistent Truncus Arteriosus
Symptoms and Signs of Persistent Truncus Arteriosus
Infants usually present with mild cyanosis and symptoms and signs of heart failure (eg, tachypnea, poor feeding, diaphoresis) in the first few weeks of life. Physical examination may detect a hyperdynamic precordium, increased pulse pressure with bounding pulses, a loud and single second heart sound (S2), and an ejection sound (click). A grade 2 to 4/6 systolic murmur is audible along the left sternal border (see table). A mid-diastolic mitral flow murmur may be audible at the apex when pulmonary blood flow is increased. With truncal valve insufficiency, a high-pitched diastolic decrescendo murmur is audible over the mid left sternal border. 