Case 1/2014 - 24-Year-Old Man with Left Single Ventricle in Chronic Hypoxia

Abstract

Clinical data: Fatigue on mild exertion and accentuated cyanosis have been noted two years ago. He was operated at 17 days and at nine months for right and left Blalock Taussig, respectively. The saturation remained above 85%, but Hct = 65% and Hb = 19 g/dl guided the performance of bidirectional Glenn at 19 years old. Cardiac catheterization at 20 years revealed average pulmonary pressure of 22 mmHg, which postponed the operative indication to complete the Fontan principle. He remained using aspirin, with oxygen saturation above 80%, Hct = 63%, and Hg = 20 g/dl. Physical examination: Eupneic, cyanotic +, normal pulses, no jugular venous distension. Weight 58 kg, height 163 cm, BP: 90/60 mmHg, HR: 78 bpm, oxygen saturation = 83%. Palpable aorta ++ at supra sternal notch. In precordium, ictus cordis at the 4th and 5th LICS and discrete systolic impulses in LSB. Hyperphonetic heart sounds, systolic murmur, + +, rough, LSB, and tip; discrete continuous murmur at supra sternal notch. The liver was not palpable.