Biography
Biography: Heba Kamal Weshahy
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 intercoronary 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 its 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.
Recent publications:
1-Weinberg PM, Natarajan S, Rogers LS. (2013) Aortic arch and vascular anomalies.
2-Uchino A, Saito N, Okada Y, et al.(2013) Variation of the origin of the left common carotid artery diagnosed by CT angiography.
3-Mosieri J, Chintala K, Delius RE, Walters HL 3rd, Hakimi M.(2004) Abnormal origin of the right subclavian artery from the right pulmonary artery in a patient with D-transposition of the great vessels and left juxtaposition of the right atrial appendage an unusual anatomical variant.
4-Pena E, Nguyen ET, Merchant N, Dennie C (2009) ALCAPA syndrome not just a pediatric disease.
5-Yua J, singh R, Halpern EJ, Fischman D (2011) anomalous origin of the left coronary artery from the pulmonary artery.
6-Atik E, Tanamati C, Kajita L, Babero-Marcial M (2006) unilateral pulmonary artery agenesis.
7-Deutsch MA, Thieme SF, Hinterseer M, (2010) adult presentation of combined unilateral atresia of the right proximal pulmonary artery and left patent ductus arteriosus.