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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 6, November/December 2015
AFRICA
e9
have been noted to be a precipitating factor of TGA. Ultrasound
studies during the Valsalva manoeuvre demonstrate a reduction
in lumen diameter of the superior vena cava due to increased
intrathoracic pressure, which causes obstruction of the venous
blood flow transmitting venous back pressure towards the
brain.
10
While the association between AD and TGA remains
unclear, the shared common precipitant of raised intrathoracic
pressure may provide a link between the two processes.
Conclusion
This report emphasises the importance of detailed physical
examination in patients with pure TGA. Physicians should be
aware of such a possibility and suspect AD in patients with pure
TGA.
To our knowledge, this is the second case report of a patient
with AD presenting with pure TGA syndrome.
10
In the only other
case reported, the patient had a fatal outcome. This is therefore
the first case report of a patient surviving after admission with
AD presenting as pure TGA syndrome.
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