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Spot Diagnosis ( congenital heart disease )

Discussion in 'Spot Diagnosis' started by neo_star, Dec 17, 2012.

  1. neo_star

    neo_star Moderator

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  2. Carmen

    Carmen Active member

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    Maybe is a cardiomegaly
     

  3. taapataas

    taapataas New Member

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    boot shaped heart
    tetralogy of Fallot
     

  4. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    Fallot tetralogy.
     

  5. neo_star

    neo_star Moderator

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    Hint : Everything that wheezes is not asthma, similarly everything heart that looks like a boot in pediatric CXR is not TOF. It's to drive home this point, that i put this case up....but becos i said differentials r welcome, i will accept TOF as a differential, but this is not TOF.
     

  6. taapataas

    taapataas New Member

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    Dif dg: Ebstein anomaly, Tricuspid atresia
     

    Last edited: Dec 17, 2012
  7. kangourou

    kangourou Famous Member

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    This is an excellent image Neo_star, thank you! I have spent some time looking at this image, as I too thought of ToF on first glance. However on further inspection I am convinced this is aortic coarctation. If you look closely at the "aortic knuckle" you can see the classical indent - the so called "figure of 3 sign" (which I failed to spot on first glance - it's quite subtle). Then, look at the ribs on both sides: you can see the classic notching of the ribs caused by dilated intercostal collateral vessels (Roesler sign).
     

    Last edited: Dec 17, 2012
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  8. maruis

    maruis Moderator

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    coarctation of the aorta. agree with the above
     

  9. dr.angela

    dr.angela Bronze Member

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    Fallot tetralogy
     

  10. Rocket Queen

    Rocket Queen Super Moderator

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    Aortic coarctation
     

  11. neo_star

    neo_star Moderator

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    Ans: Coarctation of aorta

    as demonstrated by the subtle "figure of 3 sign" and the rib notching.


    Credit to Dr. kangourou for clinching the diagnosis.
     

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