Abstract
Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac defect with atrioventricular and ventriculoarterial discordance which leads to heart failure and limits patients’ lifespan. We report the case of a 70-year-old lady, from a poor province in Pakistan, who presented for the first time with palpitations and was diagnosed to have CCTGA. She had moderate pulmonic valve stenosis which was protective against heart failure. She had six children all born via spontaneous vertex delivery in her local village. This case exemplifies the fact that pulmonic stenosis is favourable for patients with CCTGA. In a country where the average life expectancy of females is only 68 years, the survival of our patient with CCTGA beyond the average lifespan is indeed interesting.
Highlights
Introduction von Rokistansky in1875 was the first to describe a congenital cardiac anomaly known as the congenitally corrected transposition of the great arteries (CCTGA) [1]
CCTGA is a defect whereby the right atrium is connected to the left ventricle, supplying blood to the pulmonary artery, whereas the left atrium is connected to the right ventricle, supplying blood to the aorta [2]
We describe the case of a 70-year-old lady from Pakistan, who presented for the first time in the clinic with palpitations and was found to have CCTGA with associated pulmonic stenosis
Summary
Up to 90% of patients with CCTGA are reported to have other cardiac anomalies like tricuspid or mitral valve abnormalities, pulmonary artery stenosis and ventricular septal defects [7], the latter two being the most common [2]. Symptomatology of these patients depends on the criticality of the associated anomalies and right ventricular function [8]. What is even more fascinating is that she successfully gave birth to six children via spontaneous vertex delivery in a remote village with minimal medical facilities This shows that CCTGA patients even with associated cardiac defects can conceive and deliver uneventfully. She remained in normal sinus rhythm even during the times when she felt palpitations
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