The median survival of patients with truncus arteriosus is five weeks of age with rare cases reaching adulthood. The longest reported survivor with balanced ventricles, as the index case has, is 38 years of age. The index case is a 46-year old male with Type 3 truncus arteriosus. His case has never been documented in the English Literature as far as the author is aware.

Aortic dissection and rupture occur in 20-40% of patients with Marfan's syndrome. This occurs predominantly in the third and fourth decade of life, contributing to the increased morbidity and mortality of this specific group of patients. This is the first known documented case report of prepubertal left coronary sinus rupture with left coronary artery aneurysms with fistulous communication to both the superior vena cava and right superior pulmonary vein, presenting with a continuous murmur.

Arrhythmogenic right ventricular dysplasia is a rare entity and a significant cause of sudden death especially in the Italian population and athletes. The familial form is uncommon especially in the Afro-Caribbean population. This Index family represents an Autosomal Dominant form in a maternal parent who had sudden death at 39 years of age. The Index case was diagnosed at 18 years with increasing palpitations since 8 years of age, becoming symptomatic two decades younger than her mother. This was confirmed using the Treadmill Stress test. This is the 1st Case of Familial Arrhythmogenic right ventricular dysplasia documented in an Afro-Caribbean family. Learning objective Familial Arrhythmogenic right ventricular dysplasia is a rare entity and a significant cause of sudden death especially in the Italian population and athletes. This the first case of Autosomal Dominant type of ARVD with variable penetrance, documented in an Afro-Caribbean family where diagnosis was aided by Ventricular Tachycardia occurring during a Treadmill Stress Test. Keywords Arrhythmogenic right ventricular dysplasia • Ventricular tachycardia • Familial • Gene Imprint Sandra Williams-Phillips. Familial arrhythmogenic right ventricular dysplasia in afrocaribbeans: treadmill stress test the key to early diagnosis; Cardiometry; No.4;

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Left atrial isomerism (LAI) is a rare congenital anomaly usually associated with major or minor congenital cardiac lesions. Presentation beyond childhood is unusual as there is usually high morbidity of 63% associated with the co-morbid major congenital cardiac lesions in the first year of life. The four index cases highlight the myriad cardiac lesions facilitating survival into adolescence and adulthood of this rare cardiac condition. Presented are markedly different echocardiographic findings of four cases of LAI in Afro-Caribbeans who had no intervention. Their diagnostic transthoracic echocardiographic findings are the focussed features of this article and the first documentation of isolated patent ductus arteriosus with LAI. Fascinating diagnostic chest X-ray findings of the LAI index cases are presented. They are the first cases of LAI documented in Afro-Caribbeans.