Macías-Garrido E, Cuellar-Gamboa L, Amador-Mena E

Language: Spanish
References: 8
Page: 68-73
PDF size: 265.30 Kb.

ABSTRACT

Thirty eight years old male admitted to the hospital with easy fatigability, sickness and blackout, oppressive chest pain, dyspnea, palpitations, anxiety, and syncope with exert. At physical examination had mesotelesistolic ejection murmur in pulmonary focus 4/6 Levine. The electrocardiogram in sinus rhythm, 70 bpm, aQRS -60º, PR 0.16s, QRS 0.12s, QTc 380s, and right brundle-branch block. The echocardiography with pulmonary stenosis and valvular area of 0.9 cm². The final diagnosis was syncope secondary to severe pulmonary stenosis. As part of study protocol a cardiac catheterization was performed and showed pulmonary stenosis. During the procedure measurements was taken, with pressure on the pulmonary artery of 30 mmHg and in the right ventricle in 130 mmHg with a gradient of 100 mmHg. After the procedure he underwent to balloon valvuloplasty the valvular diameter was 25.77 mm. The pressure in the pulmonary artery was 35 mmHg and in the right ventricle was of 55 mmHg with decreased gradient of 20 mmHg. The relevance of this manuscript is the presentation of an infrequent pathology as pulmonary valvular stenosis on adult patient that was asymptomatic until 38 years old when the principal presentation of the disease was syncope.

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