Primum Atrial Defect Research Articles

A Teenager with Migrating Leg Pains and Anemia.

1. Eric J. Eckbo, MD* 2. Hana Mijovic, MD, MSc† 3. Steven Rathgeber, MD‡ 4. Kathryn Armstrong, MD‡ 5. Tobias R. Kollmann, MD, PhD† 1. *Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, 2. †Division of Infectious Diseases, Department of Pediatrics, 3. ‡Division of Cardiology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada A 14-year-old girl with a history of partial atrioventricular septal defect with a cleft mitral valve, repaired at 6 months of age, is referred to our pediatric tertiary care hospital from a community hospital with migrating leg pains and fevers. Leg pains began a week ago in her left thigh migrating to her dorsal left foot. After hospitalization, she develops right calf pain and paresthesia to the right foot. The pain fluctuates with no clear triggers, and she complains of difficulty walking. In the peripheral hospital, she received a dose of intravenous (IV) cefazolin before transfer to our facility for presumed osteomyelitis. On review of her history, she complains of a 2-month history of progressive fatigue and pallor but no weight loss. She has had tactile fevers for a week before hospitalization. Aside from paresthesias, she does not report neurologic symptoms. She is not short of breath or coughing, has no gastrointestinal or urinary symptoms, and has no skin or mucosal lesions. Her underlying cardiac diagnosis was a partial atrioventricular septal defect with a primum atrial defect and cleft mitral valve. She underwent patch repair of the primum septal defect at 6 months of age and has been stable with persistent mitral valve regurgitation, followed regularly by cardiology. An echocardiogram 6 weeks before presentation was reported to be stable with stable mitral valve regurgitation. Her travel history is unremarkable. She is not sexually active and denies alcohol or substance use. She has not undergone any recent surgical or invasive dental procedures. On examination …