Corrected transposition of the great arteries, with good natural evolution in a 65-year-old woman

The patient evolved without symptoms, doing her usual activities of daily living, such as housekeeping and dressmaking, when total atrioventricular block was identified during a routine evaluation with a heart rate of 66 bpm. At this time, a diagnosis of corrected transposition of the great arteries was made through the echocardiogram, with mild left atrioventricular valve regurgitation. Due to insufficient chronotropism and binodal disease, an atrioventricular pacemaker was placed on the right when she was 59 years old. She remained asymptomatic using antihypertensive medication, amlodipine, enalapril and hydrochlorothiazide. She denied any symptoms such as palpitations, chest pain or fatigue. Physical examination: good overall status, eupneic, acyanotic, normal pulses in the four limbs. Weight: 61 Kgs, Height: 147 cm, BP=118x70 mmHg: 118 x 70 mm Hg, HR: 72 bpm. Precordium: apical impulse on the left hemiclavicular line and somewhat impulsive, without systolic impulses on the left sternal border. Hyperphonetic heart sounds, with splitting of the second sound. Mild systolic murmur +/++/4, more audible at the cardiac apex. Scar in the left infraclavicular region by the pacemaker implantation. Nonpalpable liver and clear lungs. (author)