Pediatric clinical CT cases
Heba Kamal Weshah
National Heart Institute, Egypt
: Int J Cardiovas Res
Abstract
1. Dilated cariomyopathy in a four years old girl: Clinical picture: dysnea, respiratory distress, cardiomegaly and gallop. Echocardiography: dilated left ventricle with impaired contractility EF 20%, FS 10%. CT angiography: Absent left main coronary artery. Anomalous origin of the LCX and LAD by separate ostia from the left side of the main pulmonary artery. Diffuse dilatation of the RCA. Many dilated inter-coronary collaterals. Conclusion: adult type of ALCAPA. 2. Dilated cardiomyopathy in a ten months old girl: Clinically: dysnea, recurrent pneumonia, respiratory distress, cardiomegaly and gallop. Echocardiography: dilated left ventricle with impaired contractility EF 22%, FS 10%, suspected ALCAPA. CT: Anomalous origin of the LAD from the left side of the main pulmonary artery. The left circumflex arises from the left coronary sinus of Valsalva and runs its normal course, Mild diffuse dilatation of the RCA. Conclusion: ALCAPA. 3. ASD with severe pulmonary hypertension: Clinically: 9 months old female, recurrent pneumonia, feeding difficulties, poor weight gain, cardiomegaly and accentuated S2. Echocardiography: dilated RV, severe TR, moderate sized secundum ASD and pulmonary hypertension. CT: Average sized main pulmonary artery continuous with its left branch. Absent right pulmonary artery, Indirect MAPCA supplying the right lung, Diminished right lung volume. 4. Tetralogy of Fallot with upper limb weakness): Clinically: 20 months old female, dysnea, cyanosis, left upper limb weakness, and systolic murmur. Echocardiography: TOF. CT: Average sized confluent main pulmonary artery and it’s both branches. Abnormal origin of the left subclavian artery from the left pulmonary artery. Right sided aortic arch. 5. Postoperative Residual VSD): Clinically: 18 months old female, 6 months following surgical closure of VSD and epicardial pacemaker insertion, dysnea, respiratory distress, pansystolic murmur. Echocardiography: abnormal flow directed from the aorta to the RV, suspected ruptured sinus of Valsalva. CT: Residual VSD between the LVOT and RV cavity just below the Tricuspid valve.
Biography
Heba Kamal Weshahy, assistant lecturer of pediatrics and pediatric cardiology in National Heart Institute, Egypt. She has M.B.B.Ch degree in medicine in December 2004- Cairo University, Master degree in pediatrics and neonatology in August 2009- Cairo University, studying MD degree in pediatrics and pediatric cardiology- Cairo University. She has about 12 years experience in pediatric cardiology, multislice CT angiography, pediatric echocardiography, pediatric diagnostic and interventional catheterization, medical and surgical pediatric cardiac intensive care unit and congenital cardiac magnetic resonance imaging. She did about 2000 multislice CT angiography for cases of congenital heart diseases of the heart and blood vessels, about 4000 echocardiography for cases of congenital heart diseases, about 100 interventional catheterization for cases of congenital heart diseases and about 50 diagnostic catheterization for cases of congenital heart diseases.
