NREMT Paramedic Practice

What characterizes Total Anomalous Pulmonary Venous Return (TAPVR)?

1. Improper attachment of pulmonary veins

2. Reduced oxygenation of blood in the heart

3. Increased systemic and decreased pulmonary venous return

4. Obstruction in the aorta

The correct answer is: Improper attachment of pulmonary veins

Total Anomalous Pulmonary Venous Return (TAPVR) is primarily characterized by the improper attachment of pulmonary veins. In this congenital condition, the pulmonary veins, which normally return oxygenated blood from the lungs to the left atrium, instead drain into the right atrium or a systemic venous structure. This abnormal connection is what defines TAPVR and leads to significant hemodynamic consequences. Understanding the significance of this abnormality is crucial. Since the oxygen-rich blood is not properly routed, it can lead to a mix of oxygenated and deoxygenated blood flowing through the heart and into systemic circulation, resulting in decreased oxygenation of blood delivered to the body. However, the defining characteristic of TAPVR remains the misrouting of the pulmonary veins, which is what sets this condition apart from other cardiovascular anomalies. While reduced oxygenation of blood is a consequence of TAPVR due to improper blood flow, and there are variations in the presentation concerning pulmonary and systemic venous return, it is the improper attachment of the pulmonary veins that is fundamental to the diagnosis of TAPVR.