Late presentation of Noonan syndrome as atrial flutter in an adult

Noonan syndrome is a rare genetic disease with multisystemic manifestations, typically diagnosed in infancy and childhood. This case report presents 53-year-old woman no significant medical history who presented shortness of breath was subsequently syndrome. The patient exhibited characteristic facial dysmorphology, including narrow face, low set ears, pectus excavatum. Physical examination revealed crescendo-decrescendo ejection murmur bilateral lower limb edema. Atrial flutter rapid ventricular response detected, further investigations large secundum atrial septal defect (ASD) other cardiac abnormalities consistent transferred to tertiary center for evaluation management by adult congenital specialists. highlights the atypical presentation adulthood emphasizes importance recognizing this condition patients anomalies, as it can impact perioperative necessitates counseling.
 Keywords: syndrome, disease, defect,