Echocardiographic findings in persistent truncus arteriosus in a young adult

The clinical, haemodynamic, and echocardiographic features of persistent truncus arteriosus in a young adult are presented. Several echocardiographic abnormalities were observed, namely (I) diastolic fluttering of the anterior mitral leaflet, (2) dilatation of the 'aortic ' root, (3) four 'aortic ' valve cusp echoes, (4) separation of the 'aortic ' cusps during diastole, (5) dilatation of the right ventricle with paradoxical motion of the septum, (6) the anterior wall of the 'aorta ' was anterior to the septum and the posterior 'aortic ' wall posterior to the closed position of the mitral valve. The significance of these findings is discussed. Since the introduction of echocardiography in I954 by Edler and Hertz (I954), several workers have confirmed its usefulness in the evaluation of patients with valvular heart disease (Joyner and Reid, I963; Joyner et al., I967; Gramiak and Shah, I970). More recently this technique has been found to be a valu-able aid in the diagnosis of congenital heart disease. Characteristic findings have been described in atrial septal defect (Diamond et al., I97I), Ebstein's ano-maly (Lundstrom, I973), double outlet right ventri-cle (Chesler et al., I97I), transposition of the great arteries (Gramiak et al., I973), and tetralogy of Fallot (Chung et al., 1973). Patients with truncus arteriosus usually present with cardiac failure and cyanosis during the neo-natal period. Survival to adult life is rare (Tandon, Hauck, and Nadas, I963). In this report we describe the haemodynamic and echocardiographic features of truncus arteriosus with associated ventricular septal defect, atrial septal defect, and incompetence of the truncal valve, in a 2i-year-old woman