JACC. Case reports · 2025
Undiagnosed Perimembranous Ventricular Septal Defect Presenting as Congestive Heart Failure in an Elderly Woman.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Panduranga Varshitha T, Masara Maureen, Kurnick Adam, Talanki Varsha, Chandrakumar Harshith P, Dubey Siddharth, John Sabu
Аннотация
BACKGROUND: A hemodynamically significant ventricular septal defect (VSD) typically manifests in children but is uncommon in adults. The long-term outcomes of unrepaired small VSDs in the elderly population are not well known because they rarely become hemodynamically significant.
CASE SUMMARY: A 77-year-old woman presented with newonset heart failure and atrial fibrillation. A transthoracic echocardiogram showed a small peri-membranous (VSD) with "windsock deformity," a left-to-right shunt, and severely reduced ejection fraction. She experienced cardiogenic shock requiring inotropic support and later died.
DISCUSSION: Unrepaired small VSDs presenting as acute heart failure in elderly patients have rarely been reported. This unique case helps to inform other practitioners of potential long-term outcomes of unrepaired small VSDs.
TAKE-HOME MESSAGES: Unrepaired VSDs in adults present a complex clinical challenge because of their uncertain long-term outcomes and limited data. This rare presentation in advanced age underscores the importance of early recognition and timely management.
CASE SUMMARY: A 77-year-old woman presented with newonset heart failure and atrial fibrillation. A transthoracic echocardiogram showed a small peri-membranous (VSD) with "windsock deformity," a left-to-right shunt, and severely reduced ejection fraction. She experienced cardiogenic shock requiring inotropic support and later died.
DISCUSSION: Unrepaired small VSDs presenting as acute heart failure in elderly patients have rarely been reported. This unique case helps to inform other practitioners of potential long-term outcomes of unrepaired small VSDs.
TAKE-HOME MESSAGES: Unrepaired VSDs in adults present a complex clinical challenge because of their uncertain long-term outcomes and limited data. This rare presentation in advanced age underscores the importance of early recognition and timely management.