Common Aorto-Pulmonary Trunk: A Rare Congenital Defect

A lad of eighteen was first seen on May 18, 1942. A congenital heart lesion had been diagnosed when he was a few weeks old, and though he was not then cyanosed at rest, he soon became blue and breathless on exertion, especially in cold weather. He had scarlet fever at the age of ten, but never rheumatism in any form. At the age of twelve, he was too breathless for any but short walks. He was unfit to play any games at school. A change had taken place six months before (October, 1941) when cyanosis became permanent and the dyspncea more distressing. There had been neither orthopncea nor cedema; he had never fainted, and he had not lost weight. Pain had started during these last months of increased dyspncea, and now constituted the greater complaint, though he was no complainer. On exertion it began in the left arm and if severe it affected the right. It was felt across the chest, especially on the left, but not in the back. Rest, especially if with warmth, relieved it, yet it might last 10 to 20 minutes once evoked by exertion, for it never began at rest. Palpitation was felt on emotion or exertion. There was a slight occasional cough.