• Truncus Arteriosus—Child

    Definition

    Truncus arteriosus is a very rare heart defect. The heart has four chambers: two atria and two ventricles. In a normal heart, blood travels from the right ventricle through the pulmonary artery to the lungs. After oxygenated blood comes back to the heart, blood is pumped out of the left ventricle through the aorta to the rest of the body.
    With truncus arteriosus, one large vessel forms, instead of the pulmonary artery and the aorta. Also, in the two ventricles of the heart, part of the wall that divides the chambers is missing. Because of these defects, oxygen-rich blood is not circulated normally through the body.
    Heart Chambers and Valves
    heart anatomy
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    Blood Flow Through the Heart
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Truncus arteriosus is a congenital defect. This means that the heart forms incorrectly while the baby is in the womb. It is not known exactly why some babies’ hearts develop this way.

    Risk Factors

    Some risk factors for congenital heart disease may include:
    • Chromosomal disorders (eg, Down syndrome , DiGeorge syndrome )
    • Conditions during pregnancy, such as:
      • Being infected with a virus (eg, rubella )
      • Having poorly controlled diabetes
      • Drinking alcohol
      • Taking certain medicines (eg, thalidomide )

    Symptoms

    Symptoms may include:
    • Blue or pale grayish skin color
    • Fast breathing
    • High blood pressure
    • Irritability
    • Poor feeding/poor weight gain
    The doctor may also detect a fast heart rate during the exam.
    This condition can lead to heart failure . If your child has any of these symptoms, get medical care right away.

    Diagnosis

    Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:
    • Blood tests, blood pressure tests, and oxygen saturation tests
    • Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart
    • Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest
    • Electrocardiogram —a test that measures the electrical activity of the heart

    Treatment

    Talk with the doctor about the best treatment plan for your child. Treatment options include:

    Surgery

    Surgery is usually done right away, during infancy. The type of surgery depends on how severe the defect is. The goals are to improve circulation, which may be done by:
    • Creating a new pulmonary artery to carry blood to the lungs
    • Creating a new aorta to carry blood to the rest of the body
    • Closing the hole in the wall between the lower chambers of the heart
    Other surgeries may be needed as your child grows.

    Medication

    Before surgery, you child may need to take:
    • Diuretics—to decrease fluid retention
    • Digoxin (Lanoxin)—to improve heart function
    After surgery, your child may need antibiotics prior to some medical or dental procedures. This is to prevent an infection in the heart.

    Lifelong Monitoring

    Your child will have regular exams from a heart specialist.

    Prevention

    Preventing fetal heart defects may not always be possible, but you can reduce your risk by:
    • Practicing good prenatal care:
    • Visit the doctor regularly to monitor your health and the health of the baby. (Prenatal tests may detect a heart defect in a growing fetus.)
    • Make sure you:
      • Have a healthy lifestyle
      • Eat nutritious food and take prenatal vitamins
      • Do not drink alcohol, smoke , or use drugs during pregnancy
    • Practicing good hygiene and staying away from people who are sick

    RESOURCES

    American Family Physician http://www.aafp.org/

    American Heart Association http://www.americanheart.org/

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca/

    Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/

    References

    American Heart Association. How your cardiologist diagnoses heart defects. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=152 . Accessed July 6, 2010.

    American Heart Association. Truncus arteriosus. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Truncus-Arteriosus%5FUCM%5F307040%5FArticle.jsp . Accessed July 8, 2010.

    DynaMed Editorial Team. Truncus arteriosus. EBSCO DynaMed website. Available at:  http://www.ebscohost.com/dynamed/what.php . Updated April 29, 2010. Accessed July 23, 2010.

    Johns Hopkins University, Cove Point Foundation. Truncus arteriosus. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=truncusarteriosus1 . Accessed July 8, 2010.

    Mayo Clinic. Truncus arteriosus. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/truncus-arteriosus/DS00746/DSECTION=treatments-and-drugs . Updated July 8, 2010. Accessed July 23, 2010.

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