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Case Reports
. 2021 Nov 12;8(1):20210069.
doi: 10.1259/bjrcr.20210069. eCollection 2022 Jan 1.

Swiss cheese interventricular septum presenting with catastrophic stroke: the potential role of ECG-gated CTA

Weibo Fu  1 , Lauren Gates  2 , Mohamed Issa  3 , William B Bates  1 , J Jeff Carr  2 , Wael Aljaroudi  1 , Vincent Sorrell  3 , Michael A Winkler  1
Affiliations
Case Reports

Swiss cheese interventricular septum presenting with catastrophic stroke: the potential role of ECG-gated CTA

Weibo Fu et al. BJR Case Rep. .

Abstract

Ventricular septal defect is a common congenital cardiac condition that presents in a variety of morphologies. Less commonly, when an individual patient is found to have multiple ventricular septal defects, the term "Swiss cheese ventricular septal defect" is applied. Although not routinely utilized in clinical practice, electrocardiogram (ECG)-gated computed tomographic angiography (CTA) has been shown to provide utility in detecting intracardiac shunts, demonstrating promise in preventing acute strokes secondary to a paradoxical embolus from occurring; this is especially important when atypical cardiac septa are suspected. This case seeks to illustrate how usage of ECG-gated CTA can assist in early detection and prevention of adverse outcomes resulting from an atypical presentation of a ventricular septal defect.

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Conflict of interest statement

Competing interests: We wish to confirm that there are no known conflicts of interest associated with this publication.

Figures

Figure 1.
Figure 1.
2-mm thick multiplanar reformation (MPR) images of the interventricular septum in cross-sectional (a, b) and lengthwise (c,d) orientations. Images on the left (a,c) are derived from the initial non-gated CTA. Images on the right (b,d) are derived from the follow-up gated-CTA exam
Figure 2.
Figure 2.
Curved planar reformation (CPR) images through the largest septal defect (arrows); images (a) pseudo-three chamber view; (b) pseudo-short axis view
See this image and copyright information in PMC

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