Echocardiographic diagnosis of divided right atrium

Abstract

N 8-YEAR-OLD GIRL PRESENTED AT OUR INSTITUtion with a 6 month history of increasing peripheral oedema, ascites, hepatosplenomegaly, and biopsy-proven hepatic cirrhosis of unknown aetiology. Transthoracic echocardiography revealed leftward deviation of the atrial septum, and dilation of the caval veins. Flow from the caval veins was restricted by a single opening in a shelf separating an anterior, supratricuspid, component of the right atrium from a posterior systemic venous sinus to which the caval veins connected (Fig. 1). The mean pressure gradient between the two atrial components, estimated by pulse wave Doppler, was 20 mmHg. Transoesophageal echocardiography confirmed the diagnosis of divided right atrium (Fig. 2;