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Cor triatriatum dexter: antemortem diagnosis in an adult by cross sectional echocardiography
A Trakhtenbroit1, P Majid, R Rokey
1Department of Internal Medicine, Baylor College of Medicine, Houston, Texas.
Insights
Cor triatriatum dexter, a rare heart defect, involves a divided right atrium. Echocardiography in a patient with Ebstein's anomaly revealed the membrane's position and perforations, aiding diagnosis.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Anatomy
Background:
- Cor triatriatum dexter is a rare congenital cardiac anomaly characterized by subdivision of the right atrium.
- It results from the persistence of the right sinus venosus valve and often coexists with other right heart malformations.
- Antemortem diagnosis can be challenging, with findings frequently discovered post-mortem.
Observation:
- Echocardiographic evaluation was performed on a 56-year-old female patient diagnosed with Ebstein's anomaly.
- The study examined the echocardiographic features of cor triatriatum dexter in this patient.
- Investigations were conducted before and during cardiac catheterization.
Findings:
- Echocardiography successfully visualized the dividing membrane within the right atrium.
- No significant pressure gradient was detected between the two atrial chambers.
- Perforations were identified in the central portion of the membrane.
Implications:
- Echocardiography can effectively delineate the anatomical features of cor triatriatum dexter, even in complex cases.
- The absence of a gradient and presence of perforations may influence clinical management strategies.
- Improved diagnostic capabilities for this rare anomaly can lead to earlier intervention and better patient outcomes.
Abstract:
Cor triatriatum dexter is a rare cardiac abnormality in which the right atrium is subdivided into two distinct chambers. This anomaly is generally attributed to the persistence of the right sinus venosus valve and it is frequently associated with severe malformations of other right heart structures. The antemortem diagnosis of the membrane may be difficult and its presence is often only established at necropsy. In a woman of 56 with Ebstein's anomaly the echocardiographic features of cor triatriatum dexter were examined before and during cardiac catheterisation. These investigations showed the position of the membrane, that there was no gradient between the two atrial chambers, and that there were perforations in the centre of the membrane.