Atrial flutter with slow ventricular response revealing a double discordance: A case report

Congenital corrected transposition of the great arteries also called double discordance (DD) is a rare cardiac malformation characterized by the combination of discordant atrioventricular and ventriculoarterial connections. It is rarely diagnosed in the antenatal period, and is often found in adults. Clinical recognition can be challenging, so echocardiography is often the means by which definitive diagnosis is made. Most patients have associated cardiac diseases, and conduction anomalies. We reported a case of DD diagnosed at the age of 57 years. The patient spent most of his life asymptomatic until the age of 50 years old, and started presenting heart failure symptoms. Electrocardiogram showed an atrial flutter with slow ventricular rate. Echocardiography and injected CT scan confirmed the diagnosis of DD. Patient was under medical treatment for heart failure.