Abstract
A 58-year-old man with a history of Scimitar syndrome diagnosed and surgically repaired
in early adulthood presented multiple times to the emergency department complaining
dyspnea, chest pain, and hemoptysis. Asymmetric pulmonary arterial flow rates between
left and right lungs resulted in an apparent filling defect on computed tomographic
pulmonary arteriography, which was repeatedly misdiagnosed clinically and radiologically
as a massive pulmonary embolus. This case highlights the importance of understanding
the pathophysiology and post-surgical complications of repaired congenital cardiovascular
disease. Delayed phase acquisitions are often necessary to characterize the physiology
of repaired congenital cardiovascular disease with associated shunts.
Keywords
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References
- Scimitar syndrome.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2006; 9: 56-62
- Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology.Radiographics. 2004; 24: e17
- Scimitar syndrome: a rare disease with unusual presentation.Lung India. 2009; 26: 26-29
- Anomalous pulmonary venous drainage of right lung to inferior vena cava (“Scimitar Syndrome”): clinical spectrum in older patients and role of surgery.Q J Med. 1977; 46: 463-483
- Unilateral hypoperfusion or absent perfusion on pulmonary scintigraphy: differential diagnosis.AJR. 1998; 171: 145-150
- Scimitar syndrome: twenty years’ experience and results of repair.J Thorac Cardiovasc Surg. 1996; 112: 1161-1168
- A retrospective evaluation of radiation dose associated with low dose FDG protocols in whole-body PET/CT.Australas Phys Eng Sci Med. 2012; 35: 49-53
- A survey of organ equivalent and effective doses from diagnostic radiology procedures.ISRN Radiology. 2013; 204346: 1-9
- CT artifact mimicking pulmonary embolism in a patient with single ventricle.Pediatr Cardiol. 2008; 29: 241-242
- MDCT evaluation of pulmonary embolism in children and young adults following a lateral tunnel Fontan procedure: optimizing contrast-enhancement techniques.Pediatr Radiol. 2009; 39: 938-944
- Alteration in pulmonary perfusion due to iatrogenic pulmonary vein stenosis: a mimicker of pulmonary embolism.Avicenna J Med. 2011; 1: 58-60
- Nonuniform pulmonary arterial perfusion. Pulmonary embolism.Radiology. 1970; 99: 541-548
- Spiral CT of pulmonary embolism: diagnostic approach, interpretive pitfalls and current indications.Eur Radiol. 1998; 8: 1376-1390
- Contrast dynamics during CT pulmonary angiogram: analysis of an inspiration associated artifact.J Thorac Imaging. 2004; 19: 1-7
- CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis.Radiographics. 2004; 24: 1219-1238
- Helical CT for the evaluation of suspected acute pulmonary embolism: diagnostic pitfalls.J Comput Assist Tomogr. 2000; 24: 267-273
- Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology.Eur Heart J. 2010; 31: 794-805
- ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease).Circulation. 2008; 118: 2395-2451
Article info
Publication history
Published online: March 24, 2014
Accepted:
March 13,
2014
Received in revised form:
March 3,
2014
Received:
September 18,
2013
Footnotes
☆Disclosures: The authors report no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
