Title: Late diagnosis of congenital defect presenting as aortic arch interruption
- Radosław Zwoliński, Piotr Kula, Marek Maciejewski, Anna Adamek-Kośmider, Bogdan Klotz, Andrzej Sysa, Marian Zwoliński, Jerzy Bobiarski, Janusz Zasłonka
- Case Reports
- Polish Journal of Cardiology
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- Final page:
- coarctation of aorta, aortic arch interruption, congenital defect, late diagnosis
Coarctation of the aorta is a common congenital anomaly that is usually treated in infancy or childhood. Adult patients with coarctation have a high incidence of associated cardiac disorders, including valve diseases, atrial fibrillation and ischaemic heart disease. Most patients with uncorrected coarctation of the aorta die before reaching the age of 50 from complications such as myocardial infarction, intracranial hemorrhage, congestive heart failure, infective endocarditis or aortic dissection.
We report the case of a 65 year old woman admitted to the hospital with symptoms of heart failure IV class according to NYHA. She was treated for several years for refractory arterial hypertension and concomitant stenocardia (III CCS) presented. The symptoms of heart failure had been increasing for several months. Out-patient echocardiographic examination revealed significant, increasing mitral and tricuspid valve insufficiency with progressive left ventricular dysfunction and atrial fibrillation. Patientwas referred forsurgical repair of mitral ad tricuspid valve. During hospitalization additional investigation (ECHO and angiography) revealed the discontinuity of the descending aorta at the level of isthmus. The congenital disease revealed during hospitalization was determined to be the underlying cause of all the symptoms the patient presented. Because the clinical status of the patient was very severe, she was disqualified from surgical treatment and put on medical therapy.