Clinical data Heart murmur was auscultated during routine examination at 6 years of age, with complaints of tachycardia and chest pain at that time. A diagnosis of mitral regurgitation caused by hammock mitral valve was performed and enalapril 2.5 mg/day (0.1 mg/kg) was started. She reported being asymptomatic, capable of performing physical activity. Physical examination: good overall health status, eupneic, acyanotic, normal pulses in the four limbs. Weight: 25 kg; height: 130 cm; right upper limb blood pressure: 90 x […]

Complementary tests Electrocardiography: sinus rhythm, with conduction defect in the right bundle branch in the period prior to fistula occlusion. In the late period, there was no evidence of such defect or volume overload. Chest radiography: slightly increased heart size with cardiothoracic index of 0.47 before the coronary-cavitary fistula occlusion, which was clearly decreased 5 years later (cardiothoracic index 0.41) (). […]

Additional tests Chest X-ray: normal cardiac area with a clear increase of the left atrium in a double atrial contour and a more prominent pulmonary vascular weave in the upper fields (). […]

Additional Examinations Electrocardiogram: sinus rhythm, without cavitary overloads, complete right bundle branch block and 1st degree atrioventricular block. PR: 0.22, QRS: 0.109 with complexes rSr´ in V1 and RS in V6; AP = + 0º, AQRS = + 220º, AT = + 66º. Chest X-ray: normal cardiac area (cardiothoracic index = 0.50) and linear vascular image with increased density bordering the ventricular arch (). […]

Clinical data Tiredness and palpitations during physical work for approximately 20 years, without progression. Some episodes of small-volume hemoptysis during this period. Taking enalapril for hypertension and metformin for diabetes. Physical examination: good general condition, eupneic, acyanotic. Weight: 56 Kg, Height: 160 cm, blood pressure (right arm): 140/90 mm Hg, HR: 95 bpm, oxygen saturation = 99%. […]

Clinical data A premature female twin (33-week gestation), weighing at birth 1935 g, remained hospitalized for one month due to the diagnosis of atrial septal defect (ASD) + ventricular septal defect (VSD) + persistence of ductus arteriosus (PDA). The patient gained less weight than the average children, but maintained full and similar activity, receiving furosemide and captopril, up to the age of 3 years, when her mother noticed cyanosis. […]

Clinical data He reports that, six months ago, after discreet exercise (having run about 500 meters) he felt tiredness and dizziness, malaise and skin paleness. Repeated migraines accompany the clinical status. Recent bi-Doppler echocardiography revealed the high origin of the right coronary artery at the sinotubular junction. There was no morbid past of importance. Physical examination: eupneic, acyanotic, normal pulses. Weight: 66 Kgs, Height: 169 cm, BP: 110/65 mm Hg, HR: 57 bpm, O2 saturation = 96%. The aorta was […]

Complementary examinations Electrocardiogram showed sinus rhythm and no signs of cavitary overload. The QRS complex had RS morphology in V1, qRs in V6. AP: +50°, AQRS: +80°, AT: +40°. Chest X-ray showed normal cardiac area (cardiothoracic index: 0.46). The pulmonary vascular net was normal and the medial arch was rectified. […]

Clinical data Twenty-seven-year old male patient reporting tiredness during exercise for three years, after total cavopulmonary connection with extracardiac conduit fenestration and closure with stiches of the free end of right atrioventricular valve (AV) for severe failure in double inlet left ventricle, pulmonary atresia, and aorta arising from rudimentary right ventricle. The patient had undergone right and left Blalock-Taussig shunts at 17 days and 9 months, respectively, and bidirectional Glenn shunt at 19 years old. The patient had arterial oxygen […]