Delayed presentation of transposition of the great arteries with intact ventricular septum in an 8-week-old male infant at University College Hospital in Ibadan, Nigeria

Abstract

Transposition of the great arteries is a rare type of critical congenital heart disease (CCHD) which commonly presents in the neonatal period and requires early diagnosis and intervention if the infant is to witness his/her first birthday. Here, we report a case of an 8-week-old term male infant who presented with a 2-day history of cough, breathlessness and cyanosis. Echocardiography confirmed dextro-transposition of the great arteries (d-TGA) with patent ductus arteriosus (PDA) and patent foramen ovale (PFO). The infant succumbed to cardiogenic shock due to late presentation and no access to definitive surgical intervention.

Echocardiographic imaging of neonatal transposition of great arteries: Rare case report and review of literature

“…Our index case had complete TGA Type 1, with intact interventricular septum (IVS) although it presented late due to high level of intracardiac mixing occurring thought the moderate sized ASD and a large PDA. Similar presentations have been earlier mentioned by many other authors [8][9][10][11].…”

“…Infant with d-TGA are usually born at term, while cyanosis appears within a few hours after birth. The amount of mixing of blood of the systemic and pulmonary circulation determines the survival of the TGA patients, and the clinical manifestation and the course of disease are largely dependent on this [8]. Our index case had complete TGA Type 1, with intact interventricular septum (IVS) although it presented late due to high level of intracardiac mixing occurring thought the moderate sized ASD and a large PDA.…”

“…Complete TGA consists of 4 types [8]: type 1, with intact ventricular septum; type 2, pulmonary stenosis with intact ventricular septum; type 3, ventricular septal defect, and type 4, ventricular septal defect with pulmonary stenosis. Type 1 is the most common one, followed by type 3.…”

Congenital heart disease in Africa threatens Sustainable Development Goals

“…Labaeka’s [1] case study in this issue of the SAJCC describes the fatal outcome of a baby presenting late, in extremis , with transposition of the great arteries. This is a typical example of what many African parents face when their newborn baby is diagnosed with complex congenital heart disease (CHD).…”