Testing & diagnosis for anomalous pulmonary venous return - TAPVR or PAPVR in Children

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At Boston Children's Hospital, we know that the first step in treating your child is forming an accurate, complete and timely diagnosis.

Most babies with TAPVR show symptoms on the day they’re born. Severe cases are obvious, are considered medical emergencies, and are admitted immediately to the cardiac ICU.

Less severe cases show symptoms in the first few days of life. If your newborn baby was born with a bluish tint to his skin, if he’s having difficulty breathing, or if your pediatrician hears a heart murmur, you may be referred to a pediatric cardiologist, who will perform a physical exam. Your child’s doctor will listen to your baby’s heart and lungs, measure the oxygen level in his blood (non-invasively) and make other observations that help to determine the diagnosis.

  • The definitive diagnosis of total anomalous pulmonary venous return is usually made by cardiac ultrasound (echocardiogram). A cardiac ultrasound is a diagnostic tool that evaluates the structure and function of the heart using sound waves that produce a moving picture of your child’s heart and heart valves.

Some (not necessarily all) of the following medical tests may also used to diagnose, or confirm a diagnosis of, TAPVR or PAPVR:

  • cardiac catheterization, to determine abnormal attachment of vessels. Cardiac catheterization is an invasive diagnostic procedure performed under sedation to obtain detailed visual information and measurements about the structures inside the baby’s heart.
  • cardiac MRI or CT angiogram, to define pulmonary venous drainage. Cardiac MRI is a non-invasive diagnostic tool using 3-D imaging technology produced by magnets to accurately determine the blood flow and functioning of your child's heart. Children’s multi-slice CT scanners dramatically reduce the time a child needs to remain still for an exam.
  • chest x-ray, to see if there’s fluid in the lungs. A chest x-ray is a diagnostic tool usually used to evaluate the size and spatial relationships of the heart within the child’s chest.
  • electrocardiogram (EKG), to detect signs of ventricular enlargement. An EKG is a diagnostic tool that evaluates the electrical activity of your child’s heart.

Boston Children’s an interventional catheterization pioneer

You’ll be comforted to know that Boston Children’s pioneered interventional catheterization for many congenital heart defects and is a leader in the use of this procedure.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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