Case 262.

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• A 17-year-old male adolescent presented for re-evaluation of a cardiac condition initially detected during prenatal imaging.
• The patient reported a history of exertional dyspnea, chest pain, and palpitations, though he was recently asymptomatic.
• No significant comorbidities or family history of cardiac disease were noted.

Purpose of the Study:

• To re-evaluate a congenital cardiac condition diagnosed prenatally in an adolescent male.
• To assess the long-term findings and stability of the cardiac anomaly using serial imaging modalities.

Main Methods:

• Clinical history and physical examination.
• Electrocardiogram (ECG) and graded exercise stress test.
• Cardiac Magnetic Resonance Imaging (MRI) with and without gadolinium contrast.
• Review of prior echocardiograms, cardiac MR images, CT scans, chest radiographs, and coronary angiography.

Main Results:

• Physical examination revealed a grade II/IV systolic murmur; otherwise, findings were normal.
• ECG showed sinus bradycardia and nonspecific T wave changes; exercise stress test was normal.
• Serial cardiac imaging (echocardiography, MRI, CT) over several years demonstrated consistent findings, indicating a stable, albeit previously unspecified, congenital cardiac anomaly.

Conclusions:

• The case highlights a congenital cardiac condition initially detected prenatally, which remained stable into adolescence.
• Serial cardiac imaging is crucial for monitoring such conditions and understanding their long-term progression.
• This case underscores the importance of comprehensive evaluation and follow-up for congenital heart anomalies identified during prenatal screening.