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TGA With Interarterial Course and Athletes Heart: A Diagnostic Dilemma Answered by Stress CMR

Felix Maverick R Uy1, Phong Teck Lee1, Jie Sheng Foo1

  • 1National Heart Centre Singapore, Singapore.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

This case study highlights coronary artery compression and athlete's heart in a patient with transposition of the great arteries. Cardiac MRI and stress testing were crucial for diagnosis and management.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Sports Cardiology

Background:

  • Transposition of the great arteries (TGA) is a complex congenital heart defect.
  • Athlete's heart describes cardiac adaptations to intense physical training.
  • Coronary artery compression can lead to myocardial ischemia.

Observation:

  • A patient with a history of TGA presented with symptoms suggestive of cardiac compromise.
  • Diagnostic evaluation revealed coronary artery compression.
  • The patient also exhibited features consistent with athlete's heart.

Findings:

  • Cardiac magnetic resonance imaging (CMR) identified coronary artery compression.
  • Cycle-ergometer stress CMR effectively assessed myocardial perfusion and cardiac function under stress.
  • The combined conditions posed significant diagnostic challenges.

Implications:

  • This case underscores the importance of advanced imaging in complex cardiac conditions.
  • Stress CMR is a valuable tool for managing athletes with congenital heart disease.
  • Understanding these interactions is vital for optimizing patient care and athletic participation.

Keywords:
ASO, arterial switch operationDCM, dilated cardiomyopathyECV, extracellular volumeLGE, late gadolinium enhancementLMCA, left main coronary arteryLVEDD, left ventricular end-diastolic diameterLVEF, left ventricle ejection fractionTGA, transposition of great arteriesTTE, transthoracic echocardiogramathlete’s heartcardiac magnetic resonanceiLVEDD, indexed left ventricular end-diastolic diameterstress CMRtransposition of great arteries

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