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Cyanosis in atrial septal defect with prominent crista terminalis

Hiroya Takafuji1, Hidewo Amano1, Kotaro Obunai1

  • 1Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.

Cardiology in the Young
|January 17, 2023
PubMed

Insights

Cyanosis in adults can arise from a rare right-to-left shunt in atrial septal defect. This case highlights prominent crista terminalis as a cause of this uncommon condition.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Atrial septal defects (ASDs) typically involve left-to-right shunting.
  • Right-to-left shunting in ASDs, especially without pulmonary hypertension, is uncommon.
  • Cyanosis is a potential complication of right-to-left shunting.

Observation:

  • This report details a rare case of cyanosis in a patient with an atrial septal defect.
  • The cyanosis was attributed to a right-to-left shunt.
  • A prominent crista terminalis was identified as the anatomical correlate.

Findings:

  • The prominent crista terminalis likely contributed to the interatrial right-to-left shunting.
  • This anatomical variation can lead to paradoxical embolism and cyanosis in the absence of pulmonary hypertension.
  • The case underscores the importance of considering anatomical variations in ASD physiology.

Implications:

  • Highlights a rare cause of cyanosis in adults with atrial septal defects.
  • Emphasizes the role of anatomical variations like prominent crista terminalis in shunt physiology.
  • Informs clinical evaluation and management strategies for complex congenital heart disease.

Keywords:
CyanosisGORE CARDIOFORM ASD Occluderatrial septal defectprominent crista terminalis

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