P55 A case of vein of galen malformation with atrioventricular septal defect

Background Vein of galen, is a cause of congestive cardiac failure. It can be difficult to diagnose as the clinical picture can mimic the congenital heart defects. Neonates and young infants with vein of galen can present with intractable heart failure. Objectives Vein of galen can present with features of congestive heart failure. Presence of congenital heart defect can make it difficult to diagnose. Thorough physical examination can help in early diagnosis. Methods Patient history and examination retrieved from the patient notes and images retrieved from the system. Results 5 months old child with atrial septal defect with partial anomalous pulmonary venous drainage was seen in cardiology clinic and based on failure to thrive with congenital heart defects and respiratory distress, he was admitted to the paediatric ward with the impression of heart failure. As there was congenital heart defect so the heart failure was thought to be from the congenital heart defect and it was difficult to manage as well. Later on, examination picked up a cranial bruit, MRI brain showed vein of galen malformation. Child was transferred to tertiary neurosurgery and glue embolization was performed which was uneventful. Conclusion This case illustrates the presentation of vein of galen with heart failure in a child with congenital heart defects. There was cardiac defect so that was thought to be the cause of heart failure but later on examination picked up cranial bruit and MRI brain confirmed the vein of galen malformation.