Internal Medicine

0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 8:1

1294 Renal Vein Thrombosis Repaired Congenital Heart Disease

■may slowly extend into right atrium, particularly when associated

with renal cell carcinoma. Tumor resection in this case requires

attention to avoid thrombus fracture and embolic phenomena.

■Surgical thrombectomy rarely warranted.

REPAIRED CONGENITAL HEART DISEASE

MARIA ANSARI, MD

history & physical

History

■Prior surgical repair of teratology of Fallot, transposition of great

arteries, coarctation of aorta

Signs & Symptoms

■Atrial and ventricular arrhythmias

■Eisenmenger’s syndrome

■Hypertension recurrence after coarctation repair

■Heart failure symptoms (chest pain, dyspnea)

tests

Screening

■Accurate medical and surgical history

Imaging

■Transthoracic echocardiogram usually diagnostic

differential diagnosis

n/a

management

■Endocarditis prophylaxis indicated

■Assess for development of heart failure, pulmonary hypertension,

systemic hypertension

specific therapy

n/a

follow-up

■Patients should have regular follow-up with a cardiologist annually