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Cor triatriatum: unusual cause of transient ischaemic attacks in a 67-year-old man
D Darbar1, A B Bridges, R Roberts
1Department of Cardiology, Ninewells Hospital and Medical School, Dundee, Scotland.
Insights
This study presents a rare congenital heart defect, cor triatriatum, diagnosed late in a 67-year-old patient presenting with neurological symptoms. Echocardiography proved vital in diagnosing this condition and identifying potential embolic sources.
Area of Science:
- Cardiology
- Neurology
- Congenital Heart Disease
Background:
- Cor triatriatum is a rare congenital cardiac malformation.
- Characterized by a membrane dividing the left atrium into two chambers.
- Late adult presentation is uncommon, with this case being one of the oldest at 67 years.
Observation:
- Patient presented with symptoms suggestive of embolic events: transient ischemic attack (TIA), episodic vertigo, and central retinal artery occlusion.
- Diagnosis of cor triatriatum was established following these neurological events.
Findings:
- Echocardiography confirmed the presence of cor triatriatum.
- The imaging modality was crucial in evaluating the cardiac source of potential emboli.
Implications:
- Highlights the importance of considering congenital cardiac anomalies in adult-onset neurological deficits.
- Demonstrates the diagnostic utility of echocardiography in cases of presumed embolic neurological disease.
- Underscores that cor triatriatum can manifest symptomatically even in advanced age.
Abstract:
Cor triatriatum is a rare congenital cardiac malformation, and in its most common form is characterised by a membrane that separates the left atrium into a proximal and distal chamber. First manifestation in adulthood has been reported previously, but at 67 years of age this patient is one of the oldest to present for the first time. It was diagnosed after a probable TIA, episodic vertigo and central retinal artery occlusion. The value of echocardiography in patients with neurological disease of presumed embolic origin is demonstrated here.