Ventricular septal defect

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Shortness of breath.

Patient Data

Age: 30 years
Gender: Male
x-ray

Cardiomegaly with prominence of the main pulmonary trunk. Dilated central pulmonary arteries with peripheral pruning. Pediatric type sternotomy wires with the most inferior one fractured.

Case Discussion

This patient has a history of a ventricular septal defect, which when untreated can result in pulmonary arterial hypertension and cardiomegaly. Given the patient's symptoms, consideration can be given to Eisenmenger syndrome, where there is reversal of the left-to-right shunt and cyanosis develops (but this is not proven in this patient). 

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