Informação da revista
Vol. 41. Núm. 9.
Páginas 803-804 (Setembro 2022)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 41. Núm. 9.
Páginas 803-804 (Setembro 2022)
Image in Cardiology
Open Access
Troubled adolescence
Adolescência conturbada
Visitas
...
Rita Caldeira da Rocha
Autor para correspondência
aritacrocha@gmail.com

Corresponding author.
, Renato Fernandes, Bruno Piçarra, David Neves, Manuel Trinca
Cardiology, Hospital do Espírito Santo de Évora, Portugal
Informação do artigo
Texto Completo
Baixar PDF
Estatísticas
Figuras (1)
Texto Completo
Case report

A 29-year-old male patient, with history of a heart murmur, followed by a pediatric cardiologist until the age of 17, was referred to the emergency room due to dyspnea for more than ordinary exertion and palpitations for the past ten days. Physical examination was unremarkable, aside from a holosystolic murmur. Transthoracic echocardiography (Figure 1, Video 1) revealed a slightly dilated, hypertrophic left ventricle with preserved systolic function. The right ventricle was dilated with reduced systolic function. At the aortic ring, a 26mm diameter fistual was detected, between a right sinus of valsalva aneurysm and right ventricular outflow tract, with left to right flow and a Qp/Qs of 2.5. Mild aortic regurgitation was also present. For further characterization, a transesophageal echo was performed (Figure 1, Video 2). A contrast study with agitated saline solution excluded a right-to-left shunt. The patient underwent surgical intervention, which involved aneurysm resection, sinus of valsalva defect patch repair and implantation of an aortic mechanical prosthesis.

Figure 1.

Superior row-parasternal long axis view on transthoracic echocardiogram. Inferior row-three chambers view on transesophageal echocardiogram (Video 2).

(0,55MB).

Sinus of valsalva aneurysms are rare cardiac lesions occurring with an incidence of <0.1%, and more frequently affect male patients (65-80%). The most commonly affected sinus is the right (up to 89% of cases). The definitive therapeutic option is surgery.

Loss to follow-up is a prevalent problem in patients with congenital heart disease, particularly in male adolescents. It is not unusual for these patients to be admitted years later with congestive heart failure, secondary to major structural and functional abnormalities. Pediatric-to-adult healthcare transition programs have been created as a strategy to reduce these numbers. Patients education is also fundamental at both hospital and primary healthcare levels.

Conflicts of interest

The author has no conflicts of interest to declare.

Copyright © 2022. Sociedade Portuguesa de Cardiologia
Idiomas
Revista Portuguesa de Cardiologia

Receba a nossa Newsletter

Opções de artigo
Ferramentas
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.