Congenital Corrected Transposition of the Great Arteries in a 44 Year Old Female Patient

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Abstract

Backgorund

Congenitally corrected transposition of the great arteries is an in frequent disease in adult patients. A recent worldwide report gathered 26 cases aged > 40 years.

Methods

A female with congenitally corrected transposition of the great arteries was clinically studied. Electrocardiograms, chest x-rays, color Doppler and hemodynamic studies were performed.

Results

A 44 year--old female complained of dyspnea and palpitations. Pansystolic mitral murmur together withan increased 2nd heart sound were heard. The electrocardiogram showed normal rhythm, complete bundle branch block, right precordial "q" waves together with their absence in left precordial leads. The chest x-ray demonstrated a moderate increase in the cardiac silhouette with a narrow vascular pedicle and venocapilar hypertension. Doppler identified atrioventricular and ventricular-arterial discordance as well as left Ebstein's anomaly with a severe left valvular regurgitation. Hemodynamics confirmed this diagnosis. Surgical treatment was advised.

Conclusions

This case report shows that congenitally corrected transposition of the great arteries may have a relatively good prognosis in the absence of, important associated defects. The common associated defects are left atrioventricular valve regurgitation, ventricular septal defect with or without pulmonic, stenosis, left Ebstein's anomaly, cardiac mal positions and rhythm disturbances such as progressive A-V block and atria] and ventricular ectopic beats. These defects may be suspected by signs present in the electrocardiogram, chest x-ray and Doppler studies.