A 27-year-old man of disadvantaged socioeconomic status went to the emergency department due to progressively worsening dyspnea on minimum exertion accompanied by lower limb edema. On admission his peripheral oxygen saturation was 80% in room air. Physical examination revealed central cyanosis, digital clubbing, watch-glass nails, and jugular venous distention. Laboratory tests showed hemoglobin 23 g/dl, hematocrit 70%, BNP 3000 pg/ml and hyperuricemia. The chest X-ray revealed cardiomegaly and the ECG documented sinus tachycardia with right axis deviation and right ventricular hypertrophy. Transthoracic echocardiography revealed a large common vessel (persistent truncus arteriosus) exiting both ventricles (Figure 1) and a single tricuspid valve (Figure 2) with moderate regurgitation; a subvalvular ventricular septal defect (Figure 3) was also visible. The left ventricle was severely dilated with severe global dysfunction, and there was also right ventricular dilatation with impaired global function.
Three phlebotomies were performed during hospital stay. Signs of congestion were relieved by intravenous diuretics and the patient was discharged after seven days, referred to the adult congenital heart disease clinic at the reference hospital.
Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.
Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.
Right to privacy and informed consentThe authors declare that no patient data appear in this article.
Conflicts of interestThe authors have no conflicts of interest to declare.
Please cite this article as: Delgado A, Moreira D, Marmelo B, et al. Insuficiência cardíaca aguda no adulto jovem - uma causa rara. Rev Port Cardiol. 2014;33:251–252.
