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Twenty-three year-old with pleuritic chest pain.
- Source :
-
Heart (British Cardiac Society) [Heart] 2019 Mar; Vol. 105 (6), pp. 464-469. Date of Electronic Publication: 2018 Sep 04. - Publication Year :
- 2019
-
Abstract
- Clinical Introduction: A 23-year-old woman followed at another medical centre for congenital heart disease (CHD) presented to our emergency clinic with 3 weeks of bilateral pleuritic chest pain. She returned from holiday in Greece 6 weeks earlier where a tattoo and nasal piercing had been performed. There was no history of night sweats or fever.Her temperature was 37.5°C, heart rate 120 beats/min, oxygen saturations 94% on room air and blood pressure 110/74. Her chest was clear and there was systolic murmur on auscultation. The chest radiograph showed peripheral bilateral lower zone atelectasis. The ECG demonstrated sinus tachycardia. The haemoglobin was 11.2 g/dL, white cell count 10.18×10 <superscript>9</superscript> /L, C-reactive protein 67 mg/L (normal <5 mg/L) and D dimer=430 ng/mL (normal <230 ng/mL).A pulmonary embolus was suspected and a CT pulmonary angiogram was performed (figure 1).<br />Question: Based on the CT findings, what is the most likely underlying congenital heart lesion in this patient?Bicuspid aortic valveCoarctation of the aortaFontan circulationParachute mitral valveVentricular septal defect heartjnl;105/6/464/F1F1F1Figure 1CT pulmonary angiogram (coronal views).<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Diagnosis, Differential
Electrocardiography methods
Female
Humans
Physical Examination methods
Radiography, Thoracic methods
Young Adult
Body Piercing adverse effects
Chest Pain diagnosis
Computed Tomography Angiography methods
Endocarditis complications
Endocarditis diagnosis
Endocarditis physiopathology
Heart Septal Defects, Ventricular complications
Heart Septal Defects, Ventricular diagnosis
Heart Septal Defects, Ventricular physiopathology
Pulmonary Embolism diagnostic imaging
Pulmonary Embolism etiology
Pulmonary Embolism physiopathology
Tattooing adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 105
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 30181200
- Full Text :
- https://doi.org/10.1136/heartjnl-2017-312718