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Double-chambered right ventricle in a 16-year-old patient with Williams syndrome
Wojciech Mądry1, Maciej A Karolczak1, Ewa Zacharska-Kokot1
1Department of Pediatric Cardiothoracic Surgery, Medical University of Warsaw, Warsaw, Poland.
Insights
A rare case of double-chambered right ventricle in a Williams syndrome patient was diagnosed via echocardiography. Surgical correction was successful, highlighting the importance of advanced imaging in complex congenital heart defects.
Area of Science:
- Cardiology
- Medical Genetics
Background:
- Williams syndrome is a genetic disorder associated with various cardiovascular anomalies.
- Double-chambered right ventricle (DCRV) is a rare congenital heart defect characterized by anomalous muscular septation of the right ventricle.
- The co-occurrence of DCRV and Williams syndrome is exceptionally uncommon.
Observation:
- A 16-year-old male with Williams syndrome presented with gastrointestinal bleeding, necessitating colonoscopy preparation.
- Pre-existing diagnoses included ventricular septal defect and mild pulmonary stenosis.
- Echocardiography under general anesthesia revealed hypertrophied muscular bundles causing severe right ventricular outflow tract obstruction with a 100 mmHg gradient.
Findings:
- The patient was diagnosed with double-chambered right ventricle, a condition rarely reported in individuals with Williams syndrome.
- Previous literature documented only one case of DCRV in Williams syndrome, diagnosed via invasive angiocardiography.
- Echocardiography provided crucial data for diagnosis and surgical planning.
Implications:
- This case underscores the importance of comprehensive cardiac evaluation in patients with Williams syndrome, even with seemingly unrelated presenting symptoms.
- Echocardiography is a valuable non-invasive tool for diagnosing complex congenital heart defects like DCRV in this population.
- Successful surgical correction based on echocardiographic findings demonstrates the efficacy of modern diagnostic and therapeutic approaches for rare cardiac anomalies.
Abstract:
We present a case of double-chambered right ventricle diagnosed during preparation for colonoscopy due to gastrointestinal bleeding in a 16-year-old, mentally disabled boy with Williams syndrome. The patient was previously diagnosed with ventricular septal defect and mild pulmonary stenosis. Echocardiography performed under general anesthesia revealed hypertrophied muscular bundles in the right ventricle with the maximum gradient of 100 mmHg, causing severe outflow obstruction. This type of defect is extremely rare in patients with Williams syndrome, with only one case, which was diagnosed during invasive angiocardiography, described in world literature. A successful total surgical correction was performed based on echocardiography data.
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