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INTERESTING CASES

Case History :

35 year old female with a history of known congenital pulmonary regurgitation and A history of exercise intolerance that has been gradual in onset and progressivein nature is observed since 4 years. She is unable to bear her current quality of life.She has a history of two uncomplicated pregnancies 8 and 5 years ago. She also had prior repair of scoliosis and spinal fusion.
On examination:
She is apparently well. No cyanosis (saturation 96%). BP 110/70 mmHg. Pulse 80/minute and regular. JVP upper normal. Moderate right ventricular lift. Heart sounds normal. Grade 2 ejection systolic murmur ULSB augmented by inspiration. Grade 3 low pressure diastolic murmur mid LSB augmented by inspiration. Chest clear.

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Investigation Reports :

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Discussion :

This female has congenital isolated pulmonary regurgitation. She began to become symptomatic in her early 30s as usual in these cases . Her clinical examination further supported the diagnosis. The most striking angiographic features were the hyperdynamic pulmonary artery branches reflecting the high stroke volume and diastolic run-off. The right ventricle was grade 3.

Cardiopulmonary testing showed significant objective limitation. surgical implantation of a pulmonary valve prosthesis was indicated, Because of her symptoms and the cardiopulmonary study, This should be performed by a team with particular interest and experience in this type of surgery.

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