Congenitally Corrected Transposition of the Great Arteries: An Undiagnosed Case Presenting with Heart Failure in Adulthood

A BSTRACT Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac anomaly, representing <1% of all congenital heart defects. It is defined by atrioventricular and ventriculoarterial discordance and is frequently associated with additional structural abnormalities such as ventricular septal defect, pulmonary outflow tract obstruction, or systemic atrioventricular (tricuspid) valve disease. The clinical course is highly variable; whereas some patients remain asymptomatic and undiagnosed until adulthood, systemic right ventricular (RV), dysfunction and conduction disturbances are common late complications. We present the case of a 56-year-old male who had previously undergone permanent pacemaker implantation for complete heart block at the age of 45 years, and later presented with congestive heart failure. This case underscores the importance of early recognition of CCTGA in adults, where meticulous echocardiographic evaluation and timely management play a crucial role in improving long-term outcomes.