Cor triatriatum dexter: A rare cause of myocardial infarction and pulmonary embolism in a young adult

Cor Triatriatum Dexter as an Incidental Finding: Role of Two-Dimensional Transthoracic Echocardiography

“…CTD is an extremely rare congenital heart condition characterized by a membrane that divides the RA into an upstream chamber and a downstream chamber. The upstream chamber receives venous blood from the caval system and the coronary sinus, while the downstream chamber incorporates the tricuspid valve and right atrial appendage [4]. This membrane is a reminiscent structure formed due to the persistence of the right valve of the sinus venosus, an early embryonic structure that usually recedes between the ninth and the fifteenth week of gestation [1,5].…”

“…On an echocardiogram, the membrane in CTD can usually be visualized running from the inferior to the superior vena cava. However, the Eustachian valve originates from the margin of the inferior vena cava and may show rapid movement within the RA cavity, making it easy to be identified on cross-sectional echocardiographic examination [4,5,7,8].…”

“…In symptomatic patients, it is recommended that the membrane be surgically resected. Alternatives to surgical treatment like the percutaneous catheter-based disruption of the membrane have also been suggested [4].…”

An unusual finding in a case of syncope

“…4 When symptomatic, the presentation may include heart failure, arrythmia, syncope, cyanosis, pulmonary embolism, and sudden cardiac death. [5][6][7] Pediatric literature suggests that syncope in CTD may be owing to pulmonic valve obstruction. 8,9 Atrial fibrillation, although more common in CTD's counterpart, cor triatriatum sinister, has been reported previously and warrants consideration of anticoagulant agents.…”

“…The majority of CTD is asymptomatic and is discovered incidentally during surgery for another pathology or after death in post‐mortem exams 4 . When symptomatic, the presentation may include heart failure, arrythmia, syncope, cyanosis, pulmonary embolism, and sudden cardiac death 5‐7 . Pediatric literature suggests that syncope in CTD may be owing to pulmonic valve obstruction 8,9 .…”