An adult with central cyanosis and differential pulmonary vascularity.

A 22-year-old male patient presented with progressive effort intolerance of 2-years duration. Clinical findings and investigations were suggestive of Tetralogy of Fallot (TOF). In addition, there was a conspicuous difference in the pulmonary vascularity with oligemia on the left side and relative hypervascularity on the right side. The right pulmonary artery was arising from the proximal ascending aorta and the main pulmonary artery was continuing as the left pulmonary artery. The anomalous origin of a branch pulmonary artery from the aorta (AOPA) is a rare cardiac anomaly. We report this condition in association with TOF, highlighting the differential pulmonary vascularity.

Electrogenic Cardioversion.

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Cardioversion for AF may be performed by either using direct current (DC) shock (electrical cardioversion) or using drugs (chemical cardioversion). Here we report a case of a patient with heart failure and AF, who reverted to the normal sinus rhythm on correction of hyperkalemia (electrogenic cardioversion). The patient maintained sinus rhythm during follow-up. We highlight the importance of serum potassium in patients with AF.