Giant Right Atrium Due to Congenital Dysplastic Tricuspid Valve in an Elderly Female Patient

Abstract

Isolated tricuspid valve disease is rare. We report the case of a 65-year-old female patient who presented with right heart failure. Initial echocardiographic evaluation revealed a giant right atrium (RA) with severe tricuspid inflow obstruction with regurgitation. A comprehensive two- and three-dimensional echocardiographic evaluation revealed a dysplastic tricuspid valve resulting in the inflow obstruction and regurgitation. Rheumatic and carcinoid etiologies were ruled out by relevant tests. It is very rare for dysplastic tricuspid valve to present in late adulthood. The classic echocardiographic findings are discussed followed by a brief review of the literature.

Giant Right Atrium in a Case with Rheumatic Heart Disease

“…The RA volume measured in our case was about 1000 mL which is the largest description so far described in the literature. So far, 5 cases reported in the literature other than those cases aneurysm or diverticulum of RA, but nowhere etiology was due to rheumatic heart disease . This is the first case where giant RA was caused by severe organic TR due to rheumatic heart disease where as previously reported cases were either due to dysplastic TV or idiopathic or congenital dilatation of RA.…”

“…Massive right atrium (RA) enlargement is certainly more common in children than in adults, owing to rare congenital anomalies and most commonly due to Ebstein's anomaly . RA could be enlarged in a case of rheumatic heart disease especially when associated with severe mitral valve disease, pulmonary hypertension, or severe tricuspid stenosis . We are presenting a case of 25‐year‐old female patient who presented with features of congestive heart failure.…”

“…1 RA could be enlarged in a case of rheumatic heart disease especially when associated with severe mitral valve disease, pulmonary hypertension, or severe tricuspid stenosis. 2 We are presenting a case of 25-year-old female patient who presented with features of congestive heart failure. Clinical examination revealed engorged and pulsatile jugular vein with prominent "V"-wave and large "Y" descent, grade III/VI pansystolic murmur at left lower parasternal area and pulsatile hepatomegaly.…”