This presents as higher blood pressure in the arms and lower blood pressure in the legs. Harsh holosystolic (pansystolic) murmur at the left lower sternal border
Classic for a ventricular septal defect (VSD). This may lead to the development of the delayed-onset cyanotic heart disease known as Eisenmenger syndrome. Eisenmenger syndrome is a reversal of the left-to-right heart shunt. This is the result of hypertrophy of the right ventricle over time. This causes a right-to-left heart shunt. The VSD allows deoxygenated blood to flow from the right to left side of the heart. This blood bypasses the lungs. The lack of oxygenation in the pulmonary circulation results in cyanosis. Widely split fixed S2 and systolic ejection murmur at the left upper sternal border
Classic for a patent foramen ovale (PFO) or atrial septal defect (ASD). A PFO is lack of closure of the foramen ovale. At first, this produces a left-to-right heart shunt. This does not produce cyanosis, but causes pulmonary hypertension. Longstanding uncorrected atrial septal defects can also result in Eisenmenger syndrome. Eisenmenger syndrome can result in cyanosis. Management
A medical provider (e.g. doctor) may order tests for further evaluation of a heart murmur. The echocardiogram is a common test used. This is also known as an "echo" or ultrasound of the heart. It shows the heart structures and blood flow through the heart. Further testing is usually done when symptoms that may be of concern are present. The need for treatment depends on the diagnosis and severity.
A preureteric vena cava, also known as a retrocaval ureter, is a rare congenital malformation of the right human ureter, in which the ureter passes behind the inferior vena cava, causing compression possibly leading to hydronephrosis. The prevalence of this condition is approximately 1 per 1,000 persons, with males 2-3 times more likely than females to develop the condition. Symptoms often do not manifest until those with the condition are aged in their 20s or 30s. References
"preureteric vena cava" (PDF). Retrieved 15 July 2019. Morganstern, S. L.; Seery, W. H.; Cole, A. T. (1977). "Preureteric vena cava". Urology. 9 (6): 664–666. doi:10.1016/0090-4295(77)90317-x. ISSN 0090-4295. PMID 883067.