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A case of cor triatriatum in an eighty-year-old man: transesophageal echocardiographic observation of multiple
1Department of Rehabilitation and Physical Medicine, Faculty of Medicine, Kagoshima University, Japan.
Insights
This case study highlights a rare instance of uncorrected cor triatriatum in an elderly patient, diagnosed via transesophageal echocardiography. The patient, who had sick sinus syndrome, later died from cerebral infarction.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Cor triatriatum is a rare congenital heart anomaly characterized by a membrane dividing the left atrium.
- Sick sinus syndrome is a common cause of syncope in the elderly.
Observation:
- An 80-year-old male presented with recurrent syncope due to sick sinus syndrome.
- Transthoracic echocardiography revealed a membranelike structure in the left atrium.
- Transesophageal color flow Doppler echocardiography confirmed cor triatriatum with multiple defects and shunt flows.
Findings:
- The patient received a permanent pacemaker for sinus node dysfunction.
- No surgical intervention for cor triatriatum was performed.
- The patient died from massive cerebral infarction approximately one year post-discharge.
Implications:
- This case underscores the importance of considering rare congenital heart diseases in elderly patients presenting with syncope.
- Transesophageal echocardiography is crucial for diagnosing complex cardiac anomalies like cor triatriatum.
- The findings suggest potential long-term risks associated with uncorrected cor triatriatum, even in the absence of immediate surgical intervention.
Abstract:
An 80-year-old man was admitted to the hospital because of recurrent syncope caused by sick sinus syndrome. Conventional transthoracic echocardiography showed a membranelike echo-dense structure across the left atrium. Subsequently we confirmed the diagnosis of cor triatriatum with multiple defects and shunt flows across the membrane by transesophageal color flow Doppler echocardiography. There were no other associated congenital anomalies. The patient recovered well and was discharged from the hospital after implantation of a permanent VVI pacemaker for sinus node dysfunction. No other cardiac intervention for the cor triatriatum was done except follow-up with echocardiography. About 1 year after discharge, he died of massive cerebral infarction. The cardiac autopsy findings were compatible with the transesophageal echocardiogram. This is a rare case of uncorrected cor triatriatum in an elderly patient.