Documentation Of Spontaneous Functional Closure Of A Ventricular Septal Defect During Adult Life
British Heart Journal 35: 1973; 1214-1216
View Original Source →Abstract
An infant with a symptomatic coronary artery fistula, documented by angiography, is presented. By age 5 years, clinical evidence of the fistula was no longer present. Repeat cardiac catheterization confirmed spontaneous closure of the coronary artery fistula. More information regarding the natural history of a coronary artery fistula is required before an elective surgical approach can be recommended in all asymptomatic children.
Case Details
Personal Characteristics
A man suspected with a congenital heart lesion at the age of 4, had a cardiac murmur found during routine examination. He had an undiagnosed febrile illness at the ages of 12 and 16.
Clinical Characteristics
At the age of 23, a systolic thrill and pansystolic murmur heard over the praecordium, maximal at the left sternal edge. Radiographic screening of the chest showed prominent pulmonary arteries with increased pulsation, and hyperactive left and right ventricles. At the age of 40, the signs on physical examination were unchanged, and the electrocardiogram and chest x-ray were normal.
Remission Characteristics
At the age of 40, the signs on physical examination were unchanged, and the electrocardiogram and chest x-ray were normal. Second catheterization showed no detectable step-up in oxygen saturations, and all intracardiac pressures were normal.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Serial cardiac catheterizations
Additional Notes
The clinical and radiographic impression of a ventricular septal defect was confirmed at cardiac catheterization at the age of 23. He was seen again 17 years later, asymptomatic, at the age of 40. The signs on physical examination were unchanged, and the electrocardiogram and chest x-ray were normal.