Incidental cor triatriatum discovered on multidetector computed tomography.

Area of Science:

• Cardiology
• Medical Imaging
• Congenital Heart Disease

Background:

• Cor triatriatum is a rare congenital heart anomaly characterized by a membrane dividing the left atrium into two chambers.
• It is often asymptomatic in adults due to a large fenestration but can cause significant obstruction in children.
• Accurate diagnosis is crucial for appropriate management, especially in pediatric cases.

Observation:

• A 78-year-old woman presented with symptoms suggestive of cardiac compromise, including dyspnea and chest pain.
• Echocardiography revealed severe aortic stenosis due to a calcified aortic valve.
• Computed tomography identified a functionally bicuspid aortic valve and incidentally detected a fine linear membrane in the left atrium, consistent with cor triatriatum.

Findings:

• The imaging findings were characteristic of cor triatriatum, differentiating it from other intra-atrial abnormalities like supravalvular mitral ring or thrombus.
• The presence of cor triatriatum in an adult patient with severe aortic stenosis was an incidental finding.
• The membrane's significance in this adult patient was considered minimal due to likely adequate fenestration.

Implications:

• This case highlights the importance of comprehensive cardiac imaging to identify incidental findings such as cor triatriatum, even in the presence of significant valvular disease.
• While often benign in adults, cor triatriatum requires careful evaluation, particularly in pediatric populations where it may necessitate surgical intervention.
• Understanding the imaging characteristics of cor triatriatum is essential for accurate diagnosis and to guide clinical management strategies.