title: Late diagnosis of congenital cardiovascular defect.
abstract: Coarctation of the aorta (CoA) is a common congenital anomaly that is usually treated in infancy or childhood. Adult patients with coarctation have a high incidence of associated cardiac disorders, including valve diseases, atrial fibrillation and ischemic heart disease. Most patients with uncorrected CoA die before reaching the age of 50 from complications such as myocardial infarction, intracranial hemorrhage, congestive heart failure (HF), infective endocarditis or aortic dissection. We report the case of a 65 year-old woman admitted to hospital with symptoms of heart failure NYHA class IV. She had been treated for several years for refractory arterial hypertension and concomitant stenocardia (II CCS). The symptoms of HF had been increasing over several months. Outpatient echocardiography examination revealed significant, increasing mitral and tricuspid valve regurgitation with progressive left ventricular dysfunction. The patient was referred for surgical repair of the mitral and tricuspid valves. In-hospital echocardiography and angiography revealed descending aorta discontinuity at the level of the aortic isthmus. This congenital disease revealed during hospitalization was determined to be the underlying cause of all the symptoms the patient presented. Due to the clinical status of the patient, she was discharged from surgical procedures and put on medication.
authors.affiliation: Department of Cardiosurgery, 1(st) Chair of Cardiology and Cardiosurgery, Medical University of Lodz, Poland. radekzwolinski@poczta.onet.pl
authors.forename: Radosław
authors.initials: R
authors.lastname: Zwoliński
authors.forename: Iwona
authors.initials: I
authors.lastname: Cygankiewicz
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Ammer
authors.forename: Ryszard
authors.initials: R
authors.lastname: Jaszewski
mesh_terms: D000368:Aged; D001017:Aortic Coarctation / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D001027:Aortography; D006328:Cardiac Catheterization; D002317:Cardiovascular Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology; D011237:Predictive Value of Tests; D014262:Tricuspid Valve Insufficiency / Q000209:etiology; D018487:Ventricular Dysfunction, Left / Q000209:etiology
chemical_list: D002317:Cardiovascular Agents