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Image in Cardiology
Severe reversible left ventricular dysfunction in an infant
Disfunção ventricular grave mas reversível no lactente
Ana R. Araújo
Corresponding author
ana.araujo.silva@hotmail.com

Corresponding author.
, Inês C. Mendes, Pedro Magro, Ana Teixeira, José P. Neves, Rui Anjos
Serviço de Cardiologia Pediátrica, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An eight-month old female infant had a history of poor weight gain from the age of four months and two bouts of pneumonia&#44; at five and eight months&#46; On physical examination she presented polypnea&#44; S3 and a grade III&#47;VI holosystolic murmur over the apex&#44; radiating to the axilla&#46; The chest X-ray revealed cardiomegaly&#44; with a cardiothoracic index of 60&#37;&#44; and electrocardiography showed &#62;3 mm Q waves in DI&#44; aVL and V7 and T-wave inversion in V5-V7&#44; suggestive of myocardial infarction&#46; Transthoracic echocardiography revealed left ventricular &#40;LV&#41; dilatation and global dysfunction&#44; with LV diastolic diameter &#40;LVDD&#41; 46 mm &#40;Z-score &#43;12&#46;44&#41;&#44; fractional shortening &#40;FS&#41; 16&#37; and biplane ejection fraction &#40;EF&#41; 25&#46;4&#37;&#44; severe mitral regurgitation with poor leaflet coaptation&#44; and an anomalous left coronary artery from the pulmonary artery &#40;ALCAPA&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>&#41;&#46; The patient was referred for surgery on the basis of the information obtained from these exams&#46; Surgical correction consisted of reimplantation of the left coronary artery in the aorta &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figures 3 and 4</a>&#41;&#46; The surgery and postoperative period were uneventful&#46; The patient was discharged eight days later&#44; with reduced LV dimensions and significant improvement in global systolic function &#40;LVDD 33 mm&#44; Z-score &#43;5&#46;22&#44; FS 23&#37; and biplane EF 41&#46;3&#37;&#41;&#46; Three months after the surgery&#44; the child was clinically well with normal ventricular function&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Although rare&#44; ALCAPA must be excluded as the cause of LV dilatation and dysfunction in newborns and infants&#44; since it can be surgically corrected&#44; with excellent prognosis at this age&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Article information
ISSN: 21742049
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Revista Portuguesa de Cardiologia (English edition)
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