J Korean Med Sci.  2013 Aug;28(8):1169-1173. 10.3346/jkms.2013.28.8.1169.

Evaluation of Cardiovascular Anomalies in Patients with Asymptomatic Turner Syndrome Using Multidetector Computed Tomography

• Lee SH
• Jung JM
• Song MS
• Choi SJ
• Chung WY

• KMID: 1793021
• DOI: http://doi.org/10.3346/jkms.2013.28.8.1169

Abstract

Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

Keyword

Turner Syndrome; Adolescent; Cardiovascular Malformation; Multidetector Computed Tomography

MeSH Terms

Adolescent
Blood Pressure
Cardiovascular Abnormalities/complications/epidemiology
Electrocardiography
Humans
Karyotyping
Multidetector Computed Tomography
Prevalence
Turner Syndrome/complications/*diagnosis/radiography
Vascular Malformations/complications/epidemiology
Vertebral Artery/abnormalities
Young Adult

Figure

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  Fig. 1 An aberrant right subclavian artery arising from the descending side of the aortic arch (arrow).

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  Fig. 2 The ascending aorta shows a disproportionate dilatation (A, B).

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  Fig. 3 Partial anomalous pulmonary venous return (arrow) from the left upper lobe to the left brachiocephalic vein. There was abnormal venous connection between the left superior pulmonary vein and the left brachiocephalic vein.

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  Fig. 4 A persistent left superior vena cava (arrow).

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