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British Heart Journal logoLink to British Heart Journal
. 1978 Jan;40(1):49–54. doi: 10.1136/hrt.40.1.49

Primitive ventricle with normally related great vessels and stenotic subpulmonary outlet chamber. Angiographic differentiation from tetralogy of Fallot.

M G Saalouke, L W Perry, E O Okoroma, S R Shapiro, L P Scott 3rd
PMCID: PMC481973  PMID: 626662

Abstract

Four patients with primitive ventricle and normally related great vessels with stenotic subpulmonary outlet chamber (Holmes' heart with pulmonary stenosis) are reported. The history, physical examination, and chest x-ray film are not helpful in distinguishing Holmes' heart with pulmonary stenosis from tetralogy of Fallot. Electrocardiogram often provides the first clue to the presence of Holmes' heart; left axis deviation with or without left ventricular hypertrophy is an unusual finding in tetralogy of Fallot, but common in Holmes' heart. Selective ventriculography is diagnostic: the right ventricular outflow chamber overlies the aortic root and aortic valve in the frontal view in Holmes' heart with pulmonary stenosis, but is to the left of the aortic valve in tetralogy of Fallot; no ventricular septum can be identified in Holmes' heart. The diagnosis can be suspected in a child with clinical features of tetralogy of Fallot but atypical electrocardiogram, and can be established by angiography.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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