Breathlessness and new de-saturation in a patient with congenital heart disease: a time to thrombolyse or to seek specialist help?
A patient with known repaired complex congenital heart disease was referred as an emergency with increasing breathlessness on exertion. He was not short of breath at rest and had a saturation of 85% in air. A CT pulmonary angiography demonstrated decreased flow from his right ventricle to pulmonary artery, which was thought to be due to pulmonary embolism. We reviewed the CT with a knowledge and understanding of his anatomy and found that he had developed a false aneurysm of his right ventricular outflow tract, which required surgical treatment.
Department of GuCH, The Heart Hospital, London, UK. elizabethorchard@hotmail.com
Elizabeth A
EA
Orchard
Nathalie
N
Picault
Victor
V
Tsang
Fiona
F
Walker
D017541:Aneurysm, False / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography; D000075202:Contraindications; D003937:Diagnosis, Differential; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods*; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery