title: [Anomalous mitral arcade: a disguised and silent lesion leading to a recurrent wheezing in children. A case report].
abstract: Recurrent wheezing is a very common clinical ailment throughout infancy and childhood. The most common diagnosis in children with wheezing is asthma. However, some other causes should be considered in the differential diagnosis such as a congenital cardiac defect. We present a case of a four year old boy presenting with recurrent wheezing who was referred to our institution for cardiac evaluation. Severe mitral stenosis secondary to an anomalous mitral arcade was diagnosed by physical examination, chest X-ray, electrocardiogram and mainly transthoracic and transesophageal echocardiography. Anomalous mitral arcade is a rare congenital malformation of the mitral tensor apparatus which comprises the chordae tendineae and papillary muscles. This abnormal anatomy leads to increased filling pressure of the left ventricle, a retrograde post capillary pulmonary hypertension and interstitial aedema. The patient was referred to cardiac surgery and underwent a successful procedure with complete removal of the obstructive mitral lesion.
authors.affiliation: Servicio de Cardiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Claudia N
authors.initials: CN
authors.lastname: Villalba
authors.affiliation: Servicio de Cardiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Mariela
authors.initials: M
authors.lastname: Mouratian
authors.affiliation: Servicio de Cardiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: María V
authors.initials: MV
authors.lastname: Lafuente
authors.affiliation: Servicio de Cardiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Barretta
authors.affiliation: Servicio de Cardiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Horacio
authors.initials: H
authors.lastname: Capelli
mesh_terms: D002675:Child, Preschool; D002815:Chordae Tendineae / Q000473:pathology; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000473:pathology*; D012135:Respiratory Sounds