[Two-chambered right ventricle in an elderly patient with anoxic spells]

A 53-year-old woman with two-chambered right ventricle and ventricular septal defect (VSD) was treated by VSD closure and resection of the abnormal muscle bundle within the right ventricle. The patient remained asymptomatic only with a heart murmur until the age of 40. Then she became to get tired more easily and presented dyspnea on minimal exercise. And recently, she suffered from cyanosis with anoxic spells, which finally led her to our clinic. Cardiac catheterization showed a high pressure chamber of 110 mmHg and a low pressure chamber of 27 mmHg in the right ventricle; a pressure gradient being 83 mmHg in the right ventricle with bidirectional interventricular shunt. This disorder is rarely found in elderly patients and the natural history for patients who remain asymptomatic are still unknown. To the best of our knowledge, this is the first elderly patient to develop anoxic spells like tetralogy of Fallot and treated surgically. The case is presented here, together with a review of the literature.