Caso 2/2005

Abstract

Clinical-Surgical Correlation Braz J Cardiovasc Surg 2005; 20(1): [96][97] CLINIC DATA A male white 10-year-old patient of 34.6 kg was referred to our service. He was asymptomatic even at 6 years of age, when a heart murmur was observed and he was sent to a cardiologist. Since then, he was accompanied clinically without the use of medications. He evolved with dyspnea during exercise and another echocardiogram was taken and subsequently referred for appropriate diagnosis. The patient was in a good general state, ruddy, acyanotic and eupneic. His thorax was asymmetric with slight bulging to the left. The Ictus cordis was palpable in the 6 th intercostal space on the left hemiclavicular line. Rhythmic and normophonetic heart sounds were auscultated with a diastolic murmur at ++++/6 at the high left sternal border. The liver was located on the right costal border. Peripheral pulses of the four limbs were easily palpable. The arterial blood pressure was divergent at 110/30 mmHg. ELECTROCARDIOGRAMSinusal rhythm with a heart rate of 75 beats per minute was evidenced. The SÂP was +30º, SÂQRS was + 60º, PR interval was 0.16 seconds, QRS was 0.08 s and QTc was 0.42 s. There was no evidence of left ventricular systolic or diastolic overload. RADIOGRAMThe radiogram identified visceral situs solitus in levocardia. The cardiac area was at the upper limit and the cardiothoracic index was 0.51 with a slight predominance of the left ventricle. The lungs showed no alterations.