Differential diagnosis of cyanotic congenital heart disease

The differential diagnosis of cyanotic congenital heart disease depends on information regarding the natural history of specific malformations and clinical clues derived from the patient's history, physical examination, electrocardiogram, and chest film. Precise diagnosis is afforded by selective angiocardiography combined with cardiac catheterization measurements. Clinical and diagnostic features of some common malformations that may produce cyanosis are discussed in two groups: group 1, malformations of right-sided valves, and group 2, malformations of great vessel (arterial) origin. Illustrative angiocardiograms are presented of each of the six lesions particularly discussed: tricuspid atresia, Ebstein's malformation of the tricuspid valve, severe pulmonic stenosis with intact ventricular septum, complete transposition of the great vessels, and truncus arteriosus.