Cor Triatriatum Sinistrum: A Rarest Aetiology of Cardiac Chamber Thrombi
Mimicking Left Atrial Mass
Abstract
Background. Cor triatriatum is a rare congenital cardiac anomaly,
represent 0.1% of all congenital cardiac malformations and may be
associated with other cardiac diseases in as many as 50% of cases. The
natural history of this defect depends on the size of the communicating
orifice between the upper and lower atrial chamber. Case Presentation.
We reported case of cor triatriatum in a 12 years old girl with chief
complaint of shortness of breath, middle chest discomfort and
palpitation since 5 days prior admission. The diagnosis was based on
clinical features, chest radiography, electrocardiography and
transthoracic echocardiography. Chest radiograph showed rounded cardiac
apex and double contour appearance. ECG showed sinus rhythm, 75 beat per
minute, RAD, CCWR, RVH, RV strain pattern with ST depression and T-wave
inversion in II, III, aVF, V1-V5. TTE revealed 2 chambers of left
atrium, with restrictive supramitral membrane, dilated right atrium,
right ventricle and left atrium, smallish left ventricle, proximal left
atrial thrombus (5.96 x 3.44 cm), relative mitral stenosis, severe
mitral regurgitation, mild aortic regurgitation and severe tricuspid
regurgitation. A diagnosis of cor triatriatum sinister was made. The
only treatment is surgical correction. Medical therapy, with ampicillin
and heparin, was administered during admission. Conclusion. Cor
triatriatum has been reported in a 12-year-old girl. The diagnosis is
confirmed by clinical manifestations, chest radiography and
echocardiography. The only therapy is surgical correction. From the
field of cardiac surgeon, patients are advised to improve their general
conditions before underwent surgical procedures.