Case 3: Congenital heart disease PAH

13 Oct 2022 16:30 17:00
Function Room 7, Ground Mezzanine Floor

Patent ductus arteriosus (PDA) makes up 5 to 10% of all congenital heart diseases (CHD). Although more uncommon than atrial septal defects (ASD), clinicians caring for adult patients should be aware of PDA as they can commonly be missed in childhood and patients affected by the condition may only manifest symptoms in their mid-20’s or 30’s. The case presented is of a 28-year-old gentleman who was referred to IJN from a neighbouring hospital for typical symptoms of left and right ventricular failure. However, on review of his ECG (showing prominent right ventricular strain patterns) and an extremely trabeculated left ventricle, suspicion of a chronic congenital condition arose. Closer evaluation of his echocardiography revealed the presence of a significant PDA shunt with evidence of Eisenmenger physiology proven on right heart catheterization.
Key Points:

  • Look hard for shunts in the presence of pulmonary hypertension
  • Symptomatic PDA in adulthood is normally a BAD sign

However, Eisenmenger syndrome is NOT a death sentence