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| | THE MERCK MANUAL, Sec. 19, Ch. 261, Congenital Anomalies |
 | | Cardiomegaly, pulmonary venous congestion, and absence of LV activity on ECG as manifested by lack of a septal Q wave or positive left precordial R waves on ECG strongly suggest the diagnosis, which is confirmed by demonstration of severe hypoplasia of left heart structures on echocardiography. |
 | | However, newborns with pulmonary valve atresia and ductus arteriosus-dependent pulmonary blood flow present with severe cyanosis and a continuous murmur of ductal flow. |
 | | Catheterization and angiography are unnecessary unless significant associated defects (eg, aortic stenosis, aortic insufficiency, mitral valve disease, ventricular septal defect) are present or there is evidence that the narrow segment is not in the usual location just distal to the left subclavian artery or is longer than usual. |
| www.merck.com /mrkshared/mmanual/section19/chapter261/261b.jsp (4526 words) |
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