Left aorto-ventricular tunnel: A differential diagnosis to aortic regurgitation. 2022

A R Wong, and A Amelia, and M R Mohd Zain, and K A Sayuti
Universiti Sultan Zainal Abidin, Faculty of Medicine, Dept of Pediatrics, Malaysia. arahimwong@unisza.edu.my.

Left aorto-ventricular tunnel is a rare congenital heart disorder. A then 19-year-old young lady was referred to our clinic for chronic rheumatic heart disease with aortic regurgitation. However, because of an almost continuous murmur, and an unusual transthoracic echo, she underwent various investigations, finally revealing a rare type 2 left aorto-ventricular tunnel. She had been variously diagnosed as chronic rheumatic heart disease with aortic regurgitation, bicuspid aortic valve with aortic regurgitation, and then possibly coronary arterial (cameral) fistula (based on 2D transthoracic echo) and finally left aorto-ventricular tunnel. This is the first case described in South East Asia who is asymptomatic, apart from a murmur, and her long journey to this final diagnosis illustrates the need to "chase shadows" on echoes, to come to a proper conclusion for the patient.

UI MeSH Term Description Entries
D003331 Coronary Vessels The veins and arteries of the HEART. Coronary Arteries,Sinus Node Artery,Coronary Veins,Arteries, Coronary,Arteries, Sinus Node,Artery, Coronary,Artery, Sinus Node,Coronary Artery,Coronary Vein,Coronary Vessel,Sinus Node Arteries,Vein, Coronary,Veins, Coronary,Vessel, Coronary,Vessels, Coronary
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006330 Heart Defects, Congenital Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life. Congenital Heart Disease,Heart Abnormalities,Abnormality, Heart,Congenital Heart Defect,Congenital Heart Defects,Defects, Congenital Heart,Heart Defect, Congenital,Heart, Malformation Of,Congenital Heart Diseases,Defect, Congenital Heart,Disease, Congenital Heart,Heart Abnormality,Heart Disease, Congenital,Malformation Of Heart,Malformation Of Hearts
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000082903 Aortico-Ventricular Tunnel Congenital anomaly characterized by an extra-cardiac channel connecting the AORTA either to the right or left HEART VENTRICLE. Aortic-Left Ventricular Tunnel,Aortic-Right Ventricular Tunnel,Aortic-Ventricular Tunnel,Aortico-Left Ventricular Tunnel,Aortico-Right Ventricular Tunnel,Aorticoventricular Tunnel,Aorto-Left Ventricular Tunnel,Aorto-Right Ventricular Tunnel,Aorto-Ventricular Tunnel,Aortoventricular Tunnel,Aortic Left Ventricular Tunnel,Aortic Right Ventricular Tunnel,Aortic Ventricular Tunnel,Aortic-Left Ventricular Tunnels,Aortic-Right Ventricular Tunnels,Aortic-Ventricular Tunnels,Aortico Left Ventricular Tunnel,Aortico Right Ventricular Tunnel,Aortico Ventricular Tunnel,Aortico-Left Ventricular Tunnels,Aortico-Right Ventricular Tunnels,Aortico-Ventricular Tunnels,Aorticoventricular Tunnels,Aorto Left Ventricular Tunnel,Aorto Right Ventricular Tunnel,Aorto Ventricular Tunnel,Aorto-Left Ventricular Tunnels,Aorto-Right Ventricular Tunnels,Aorto-Ventricular Tunnels,Aortoventricular Tunnels,Tunnel, Aorticoventricular,Ventricular Tunnel, Aortic-Left,Ventricular Tunnel, Aortic-Right,Ventricular Tunnels, Aortic-Left,Ventricular Tunnels, Aortic-Right
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001022 Aortic Valve Insufficiency Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root). Aortic Incompetence,Aortic Regurgitation,Aortic Valve Incompetence,Regurgitation, Aortic Valve,Incompetence, Aortic,Incompetence, Aortic Valve,Insufficiency, Aortic Valve,Regurgitation, Aortic
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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