Liyanapathirana Chathuri, Arthanayake Shashika Mihirani, Widyaratne Sisil, Chandana Saman, Senevirathne Danajani
Provincial General Hospital, Badulla, Sri Lanka.
SAGE Open Med Case Rep. 2021 Apr 27;9:2050313X211012506. doi: 10.1177/2050313X211012506. eCollection 2021.
A 39-year-old G3P3 female presented with abrupt onset dyspnoea of one month duration. She was markedly symptomatic when lying supine and resorted to prone sleeping. Chest X-ray reported as cardiomegaly. Transthoracic echocardiography was unremarkable twice. Computed tomography chest showed a dilated pulmonary artery. Transesophageal echocardiography identified a 12-mm ostium secundum atrial septal defect with mild pulmonary hypertension. The defect was closed with a cocoon device and rendered her symptom free. This case highlights the importance of timely organization of transesophageal echocardiography when transthoracic echocardiography is negative. It also illustrates marked dyspnoea could be a presentation of undiagnosed atrial septal defect with mild pulmonary hypertension.
一名39岁、孕3产3的女性出现了持续1个月的突发呼吸困难。她仰卧时症状明显，只能趴着睡觉。胸部X线检查报告为心脏扩大。经胸超声心动图检查两次均无异常。胸部计算机断层扫描显示肺动脉扩张。经食管超声心动图检查发现一个12毫米的继发孔型房间隔缺损，伴有轻度肺动脉高压。用封堵器关闭了缺损，她的症状消失。该病例强调了经胸超声心动图检查结果为阴性时及时安排经食管超声心动图检查的重要性。它还表明，明显的呼吸困难可能是未被诊断出的伴有轻度肺动脉高压的房间隔缺损的表现。
