Clinical introduction A 32-year old man was referred to our institution for transthoracic echocardiography (TTE) following detection of an incidental murmur on physical examination before blood donation. He was asymptomatic with no significant medical history. Physical examination revealed dual heart sounds with a grade II/VI systolic murmur heard in the left sternal border. An ECG was in normal sinus rhythm. TTE was performed (figure 1A–C, online supplementary videos 1–4) followed by cardiac CT angiography (CTA) (figure 1D,E).
Question What is the diagnosis?
Ventricular septal defect.
Anomalous left coronary artery from pulmonary artery (ALCAPA).
- congenital heart disease
- cardiac imaging and diagnostics
- cardiac computer tomographic (ct) imaging
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Contributors All authors have substantial contribution to the manuscript.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study was approved by the Ethics Committee of Shaheed Rajaie Cardiovascular Medical and Research Center.
Provenance and peer review Not commissioned; externally peer reviewed.