Role of echocardiography-derived pulmonary to systemic flow ratio in diagnosing aortopulmonary window: A case report
Lamia Al Saikhan 1 * , Mahmoud Hassan 2
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1 Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA2 King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA* Corresponding Author

Abstract

Background: Aortopulmonary window (APW) is a rare congenital cardiac anomaly characterized by abnormal communication between the ascending aorta and the main pulmonary artery. Without early surgical correction, this condition has a poor prognosis. However, few case reports have described adult survival of patients with untreated APW.
Case presentation: We report the case of a 15-year-old girl who developed irreversible pulmonary hypertension due to untreated APW. Initially, we suspected the presence of an extracardiac shunt using a simple calculation of the echocardiography-derived pulmonary-to-systemic flow (Qp/Qs) ratio during a routine echocardiography study, which provided us with a clue to proceed with further multimodal diagnostic evaluation. In this report, we describe a comprehensive diagnostic workup, including right heart catheterization and computed tomography imaging, which confirmed the diagnosis of severe irreversible pulmonary hypertension secondary to a large untreated APW.
Conclusion: This case report highlights the clinical utility of the echocardiography-derived Qp/Qs ratio as a valuable, noninvasive tool for diagnosing APW, which can lead to severe irreversible pulmonary hypertension. The multidisciplinary approach demonstrated in this case serves as a valuable example for clinicians evaluating similar cases. Therefore, APW should be considered in the differential diagnosis of severe pulmonary hypertension, even in adult patients.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 21, Issue 6, December 2024, Article No: em613

https://doi.org/10.29333/ejgm/15646

Publication date: 26 Nov 2024

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Article Downloads: 126

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