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Cardiovascular Images
August 9, 2021

An Infant With Severe Heart Failure

Author Affiliations
  • 1Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
JAMA Cardiol. 2021;6(8):e212125. doi:10.1001/jamacardio.2021.2125

What is the diagnosis and cause of this infant’s heart failure? An infant presented with severe dyspnea after getting an upper respiratory tract infection. An examination found tachypnea, diffuse crackles, and a systolic murmur over the left precordium. Echocardiography revealed coarctation of the aorta (CoA) with a dilated left ventricle (LV) and severely decreased LV systolic function. Anomalous aortic origin of coronary arteries was also suspected. Computed tomography confirmed the CoA (2.3 mm) (Figure, A). Additionally, the patient’s left anterior descending coronary artery arose from the ascending aorta above the right sinus of Valsalva and had an interarterial course without any narrowing (Figure, B). A patent retroaortic left circumflex coronary artery (Figure, A) and a small right coronary artery were found originating from the right sinus of Valsalva.1

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