Patient: Female, newborn
Final Diagnosis: Scimitar syndrome variant associated with critical aortic coarctaition
Symptoms: Absence of pedal pulse • apnea • cardiogenic shock • extremely poor clinical condition • hepatomegaly • livedo reticularis • pallor • tachycardia
Medication: —
Clinical Procedure: —
Specialty: Cardiology • Pulmonology
Objective:
Rare disease
Background:
Scimitar syndrome (SCS) is a rare congenital cardiopulmonary malformation, characterized by anomalous pulmonary venous drainage from the right lung associated with aortopulmonary collateral arteries and pulmonary hypoplasia. The variant described in the case presented here, with total anomalous right pulmonary venous drainage into the superior and inferior vena cava, can be expected in 2% of patients with scimitar syndrome. To the best of our knowledge, the association between the variant of SCS and coarctation of aorta described in our patient has never been reported before in the literature.
Case Report:
A female newborn with a gestational age of 35 weeks presented with a rare combination of scimitar syndrome and aortic coarctation. The patient had a variant of SCS that included anomalous drainage of the right upper and lower pulmonary vein into the superior and inferior vena cava, respectively; relative right lung hypoplasia; and right lower lobe sequestration supplied by aortopulmonary collateral arteries that originated from the truncus coeliacus. The diagnosis was confirmed with computed tomography angiography after resection of the aortic coarctation with extended end-to-end anastomosis. Subsequently, interventional closure of the collateral artery supplying the right lower lobe was performed with an AMPLATZER™ Vascular Plug 4. The patient’s clinical course was complicated by suspicious acute endocarditis and chylous pleural effusion. After a prolonged hospitalization, she was discharged in clinically stable condition.
Conclusions:
The diagnosis of SCS should be considered when pulmonary hypertension persists after coarctation repair in a child with dextroposition of the heart and right lung hypoplasia. Successful treatment of this rare combination of conditions calls for teamwork by highly experienced specialists.
The paper presents the authors' analysis of their own treatments of intraventricular bleeding and posthaemorrhagic hydrocephalus in premature infants in the period
Učbenik je namenjen študentom obeh medicinskih fakultet, kakor tudi specializantom ginekologije in porodništva, pediatrije ter vsem zdravstvenim delavcem, ki se pri svojem delu srečujejo z nosečnicami ter novorojenci. V njem so predstavljena najnovejša dognanja na področju preeklampsije in zastoja plodove rasti ter presejalnih preiskav v prvem trimesečju nosečnosti in pri novorojenčku.
Namen: Namen prispevka je predstaviti klinični primer hemoragične kapi pri otroku.
Prikaz primera: V kliničnem primeru predstavljamo 13-letnega otroka s hemoragično kapjo, ki je bila posledica spontane krvavitve iz prirojene arteriovenske malformacije možganskih žil.
Zaključek: Čeprav je možganska kap redka bolezen pri otrocih, je pomemben vzrok za težke okvare in smrt otrok. Natančen, kliničen nevrološki pregled ter slikovna diagnostika so ključni pri prepoznavanju in zdravljenju arteriovenskih malformacij. Te so najpomembnejši vzrok za hemoragično kap pri otrocih, ki lahko ogrozijo otrokovo življenje.
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