Device and surgical closure of ASD both result in similar improvements in right heart parameters. However, device closure is associated with better preservation of TAPSE at 1 year post intervention. Intervention for older adults with ASD, when compared to younger ones, did not result in a difference in rate of right heart remodeling.
Congenital absence of pericardium is a rare condition with electrocardiogram, chest X-ray, and echocardiographic findings which may mimic those of other cardiac conditions. We present a case of a 19-year-old asymptomatic female with incidental cardiomegaly on chest X-ray and electrocardiographic and echocardiographic changes, which meet the revised task force criteria for definite arrhythmogenic right ventricular cardiomyopathy but subsequently confirmed to have congenital partial absence of pericardium on cardiac magnetic resonance imaging.
Background
Ventricular septal defect (VSD) is one of the most common congenital heart anomalies in childhood and there is an increasing prevalence of VSDs in the adult population. The long‐term risk of infective endocarditis (IE) is of concern. The aim of this study was to clarify and compare the incidence of IE in adults with repaired and unrepaired VSDs.
Methods
Patients with VSDs were identified using the Adult Congenital Heart Disease registry at the National Heart Centre Singapore. Patients were divided into Group 1 (repaired VSD) and Group 2 (unrepaired VSDs). The electronic medical records were searched for hospitalization due to IE during a 10‐year period (October 2, 2007—October 1, 2017).
Results
Four hundred seventy‐nine patients (53% male) were identified, with a mean age of 35.0 ± 13.7 years. There were 164 patients (34.2%) in Group 1 and 315 patients (65.8%) in Group 2. In total, there were eight episodes of IE from six patients (3 male, mean age of 42.2 ± 20.7 years). Two patients had recurrent IE. The overall incidence of IE was 1.67/1000 y, and this is 11–15‐fold higher compared to general adult population. The incidence of IE in Group 2 was 1.90/1000 y. There were no IE cases in Group 1.
Conclusion
Patients with VSDs, especially if unrepaired, carry a substantially increased risk of IE compared to the general population.
We report a case of coronary artery compression and athlete's heart in a patient with a history of transposition of the great arteries. We present the diagnostic dilemmas and demonstrate the use of cardiac magnetic resonance imaging and cycle-ergometer stress cardiac magnetic resonance in the management of our patient. (
Level of Difficulty: Intermediate.
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