Аудіо 00041. Asthma wheezing, earlier surgery for coarctation of the aorta

At two weeks of age this child underwent successful surgery for coarctation of the aorta with end-to-end anastomosis. Now referred for control earlier than originally intended because of failing performance. Nothing in haemodynamics explains the fatigue. No murmur on auscultation, heart sounds are covered by respiratory sounds. A long stridor is heard on expiration. Investigations for asthma were started, and the fatigue resolved with medication. Coarctation of the aorta restored with end-to-end anastomosis at the age of 2 weeks. On echocardiography the size of the left ventricle is normal, aortic valve and flow are normal, no re-coarctation. Blood pressure at the right upper extremity was 104/59 and at the lower extremity 106/45. Respiration wheezes somewhat. Age 3.0 years. Area of auscultation: right second ic (RIC2).