ABSTRACT
Long-standing left-to-right shunting across a patent ductus arteriosus (PDA) can result in Eisenmenger syndrome. In this report, we present echocardiographic findings of a 27-year-old female patient with pulmonary hypertension. In diagnostic work-up especially Doppler findings of the pulmonary artery suggested the presence of a reversed PDA as a cause of pulmonary hypertension. The diagnosis was confirmed by contrast study and computed tomography.
Subject(s)
Ductus Arteriosus, Patent , Eisenmenger Complex , Hypertension, Pulmonary , Pulmonary Artery , Adult , Ductus Arteriosus, Patent/complications , Ductus Arteriosus, Patent/diagnostic imaging , Echocardiography , Female , Humans , Hypertension, Pulmonary/complications , Hypertension, Pulmonary/diagnostic imaging , Pulmonary Artery/diagnostic imagingABSTRACT
Para-Hisian pacing (PHP) is among the most useful maneuvers in cardiac electrophysiology during sinus rhythm and identifies whether retrograde conduction is dependent on the atrioventricular (AV) node. In this maneuver, the retrograde activation time and pattern are compared during capture and loss of capture of the His bundle while pacing from a para-Hisian position. A common misconception about PHP is that it is useful only for septal accessory pathways (APs). However, even with left or right lateral pathways, as long as pacing from the para-Hisian region conducts to the atrium with the activation sequence being analyzed, it can be used to determine whether that activation is AV node-dependent or AP-dependent.