title: Chest pain on exertion after the Takeuchi repair of anomalous origin of the left coronary artery: right ventricular ischemia due to severe pulmonary outflow tract obstruction.
abstract: Right ventricular (RV) outflow obstruction (in the form of valvar or supravalvular pulmonary stenosis) is a well-known complication of the Takeuchi procedure. We describe a 13-year-old male with exertional chest pain, pulmonary stenosis, RV hypertrophy, and consequent RV ischemia, which was confirmed using stress echocardiography and single-photon emission tomography.
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Parow, Western Cape, South Africa pieter.vanderbijl@gmail.com.
authors.forename: Pieter
authors.initials: P
authors.lastname: van der Bijl
authors.affiliation: Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Faculty of Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Parow, Western Cape, South Africa.
authors.forename: Alexander
authors.initials: A
authors.lastname: Doruyter
authors.affiliation: School of Adolescent and Child Health, University of Cape Town and Red Cross Children's War Memorial Hospital, Rondebosch, Western Cape, South Africa.
authors.forename: Rik
authors.initials: R
authors.lastname: de Decker
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg and Red Cross Children's Hospitals, Western Cape, South Africa.
authors.forename: John
authors.initials: J
authors.lastname: Lawrenson
authors.affiliation: School of Adolescent and Child Health, University of Cape Town and Red Cross Children's War Memorial Hospital, Rondebosch, Western Cape, South Africa.
authors.forename: George
authors.initials: G
authors.lastname: Comitis
authors.affiliation: Department of Cardiothoracic Surgery, Red Cross Children's War Memorial Hospital, Rondebosch, Western Cape, South Africa.
authors.forename: John
authors.initials: J
authors.lastname: Hewitson
mesh_terms: D000293:Adolescent; D002637:Chest Pain / Q000209:etiology*; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology*; D005082:Physical Exertion; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011666:Pulmonary Valve Stenosis / Q000175:diagnosis / Q000209:etiology*
keywords: Sestamibi; Takeuchi; exertional angina; pulmonary stenosis; right ventricular ischemia; stress echocardiogram