Case 262: Isolated Left Ventricular Apical Hypoplasia.

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• A 17-year-old male presented for re-evaluation of a cardiac condition initially identified during prenatal imaging.
• The patient had a history of intermittent exertional symptoms including shortness of breath, chest pain, and palpitations.
• No significant comorbidities or family history of cardiac disease were reported.

Observation:

• A 17-year-old male presented for re-evaluation of a cardiac condition noted during prenatal imaging.
• The patient reported intermittent exertional dyspnea, chest pain, and palpitations, but was recently asymptomatic.
• Physical examination revealed a grade II/IV systolic murmur; otherwise, findings were unremarkable.

Findings:

• Electrocardiogram showed sinus bradycardia and nonspecific T wave changes.
• Exercise stress test results were normal.
• Serial cardiac imaging (echocardiography, MRI, CT) demonstrated stable findings over time, with normal coronary arteries on prior angiography.

Implications:

• This case highlights the importance of long-term surveillance for congenital heart disease.
• Stable findings on serial imaging suggest a potentially benign or well-compensated cardiac anomaly.
• Multimodality imaging plays a key role in assessing and monitoring pediatric cardiac conditions.