Wheezing as the sole clinical manifestation of cor triatriatum

Wheezing as a sign of cor triatriatum sinister culminating in multiple organ failure

“…Moist râles and wheezing can be heard if pulmonary edema occurs. CW as a sign of CTS, as seen in the present patient, has rarely been reported in the literature . In adolescents and adults, however, diagnosis may be incidental or delayed due to lack of symptoms, and not be established until late adulthood, when dyspnea, orthopnea, hemoptysis, atrial tachyarrhythmia, syncope, stroke, and systemic embolism emerge after calcification of the orifice .…”

“…CW as a sign of CTS, as seen in the present patient, has rarely been reported in the literature. 5,6 In adolescents and adults, however, diagnosis may be incidental or delayed due to lack of symptoms, and not be established until late adulthood, when dyspnea, orthopnea, hemoptysis, atrial tachyarrhythmia, syncope, stroke, and systemic embolism emerge after calcification of the orifice. 4 These symptoms may lead to an erroneous diagnosis of mitral stenosis, because CTS shares similar features with mitral stenosis.…”

Cor Triatriatum: Case Report of Emergency Department Diagnosis

“…Misdiagnosis of cor triatriatum as reactive airway disease or asthma has been reported occasionally. 2 , 3 , 9 , 10 Even so, the diagnosis remains elusive and challenging particularly in the ED. Given the prevalence of asthma and other reactive airway disorders in childhood, with up to 11% of all children aged 10 years having episodes of reactive airway disease, 11 it is unsurprising that a presentation as in the case above would prompt initial ED management with bronchodilators, inhaled beta-agonists, and corticosteroids.…”

“…Previous publications regarding the association between cor triatriatum and wheezing have suggested that the etiology may be related primarily to pulmonary hypertension, with pulmonary venous hypertrophy triggering spasm of pulmonary vasculature and associated bronchial smooth muscle reactivity. 2 , 3 Initial improvement with bronchodilators may be observed given that the final mechanism remains smooth muscle activation and resultant airway narrowing. As in this case, such response would be expected to be short-lived, with the patient experiencing additional pulmonary decline from pulmonary edema and associated respiratory distress.…”

“…However, when presentation is delayed, primary symptoms may mimic reactive airway disease. 2 We report a case of cor triatriatum in an older child who presented to an emergency department (ED) with a chief complaint of wheeze and dyspnea with a previous diagnosis of asthma.…”