What Are The Symptoms And Complications Of Transposition Of The Great Arteries?

Shortness Of Breath

Individuals affected by shortness of breath (dyspnea) have described the sensation as an inability to breathe deeply enough or fast enough. Infants with TGA often present with dyspnea because of their poor heart function. Because the blood enters and exits the heart without picking up any oxygen, the tissues in the body cannot function the way they should. The brain senses the tissues around the body are not receiving enough oxygen, and it activates a response to that. The body's response involves an increase in the heart rate and an increase in breathing rate. Inhalation of greater amounts of oxygen at a faster pace should be able to oxygenate the blood more efficiently, compensating for the oxygen shortage the brain has sensed. However, this mechanism is not successful for improving oxygen levels in the blood of transposition of the great arteries patients because of the defective anatomy of their heart. Nonetheless, the brain does not understand this and activates the natural mechanism anyway.

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Heart Failure

Heart failure is a fatal complication of TGA that may occur regardless of treatment or correction of the defect. Because the aorta is connected to the right ventricle rather than the left, the right ventricle takes on the workload the left ventricle was designed to take on. Specific characteristics of the left ventricle allow it to pump with enough force to send blood to all parts of the body, where the right ventricle has different characteristics geared toward pumping blood into the lungs properly. Essentially, the left ventricle pumps with higher velocity than the right ventricle does. Because the right ventricle has to take on the function of the left ventricle in TGA patients, it is more prone to structural changes that can lead to right ventricle failure and eventually heart failure. Some cases of transposition of the great arteries may inflict harsh effects on the valve between the right atrium and the right ventricle called the tricuspid valve. This valve can become damaged from the increased workload it has to take on in individuals with TGA. When surgery is utilized to switch the aorta and pulmonary artery to their correct positions, the damage of the tricuspid valve can cause tricuspid valve failure. Over time, heart failure can result from tricuspid valve failure.

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