Bs chi benh an kenh nhi that

• The congenital heart disease had been detected at 10 months old after an episode of acute bronchitis.. • Exertional dyspnea, diaphoresis, failure to thrive... PAST HISTORY• Birth weigh

CASE REPORT

PERSONNAL DETAILS

• Patient name : NGUYEN THI TO UYEN

• Gender : Female

• Birthdate : April 14, 1999

• Address : Dac Lac province

• Date of consultation : Feb 14, 2003

• Chief complaint : Dyspnea

• The congenital heart disease had been detected at 10 months old after an episode of acute bronchitis.

• Recurrent respiratory infections.

• Exertional dyspnea, diaphoresis, failure to thrive

• No cyanosis

PAST HISTORY

• Birth weight : 3kg ; 2nd daughter, the elder is normal

• Mother : normal gestation

PHYSICAL EXAMINATION

• 1st examination (April 8, 2002 - 3 years old)

W : 8.5 kg H : 82 cm HR : 130bpm

• Cardiac apex : 5th LICS, on MCL

Systolic murmur grade 4/6 at 2nd LICSSystolic click (+)

No pulmonary ralesLiver : 2 cm below costal margin

No other abnormalities

Cardiac apex : 6th LICS, 1 cm out of MCL

Systolic murmur grade 2/6 at 2nd LICS ; Diastolic murmur

of pulmonary regurgitation (+)

P2 accentuated

Liver : 4 cm below costal margin

No other abnormalities

▪ The cleft of the anterior leaflet of the mitral valve results

in mitral regurgitation (4/4) Two papillary muscles of theleft ventricle are lateralized

▪ Tricuspid regurgitation (4/4) Systolic pulmonary artery

▪ Partial atrioventricular septal defect

▪ Severe mitral and tricuspid regurgitation

▪ Pulmonary hypertension

▪ Severe congestive heart failure

CURRENT TREATMENT

• The patient is daily given:

Digoxin, diuretics, ACE-I

SURGICAL INDICATION

• Reconstruction of the atrial septum

• Mitral valve repair