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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 789-790
DOI: 10.1055/s-0041-1736161
Letter to the Editor

Imaging in Cor Triatriatum Sinistrum: A Rare Cardiac Entity

Pranav Gupta
1   Department of Radiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
,
Surabhi Kaushik
1   Department of Radiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
,
Sunil K. Puri
1   Department of Radiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
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We report a case of a 25-year-old, normotensive male patient, who presented with progressive dyspnea (NYHA III). He underwent a battery of tests including transthoracic echocardiography (TTE). which revealed a rare congenital cardiac condition that was later confirmed through a cardiac computed tomography (CT) scan.

The apical four-chamber view on TTE ([Fig. 1]) showed a thin horizontal membrane dividing the left atrium into proximal and distal segments with normal heart chambers and atrioventricular (AV) valves. Cardiac CT confirmed the findings with a thin membranous structure running horizontally to bisect the left atrium into a proximal (posterosuperior) and a distal (anteroinferior) chamber ([Fig. 2]). A fenestration was seen on the superomedial aspect of the membrane ([Fig. 3]) through which the two chambers could communicate. The distal segment was in contact with the mitral valve and contained the atrial appendage. The proximal segment received blood from all four pulmonary veins with no anomalous drainage ([Fig. 4]). On the basis of these findings, a diagnosis of cor triatriatum sinistrum (CTS) was made.

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Fig. 1 Four chamber echocardiogram image showing a thin echogenic membrane (straight arrow) dividing the left atrium into proximal and distal chambers.
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Fig. 2 Axial cardiac CT image revealing the same membrane as a thin hypodense structure (white star) which is seen to bisect the left atrium. CT, computed tomography.
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Fig. 3 Superior section on the axial CT images showing a communication between the proximal and distal parts of the left atrium (curved arrow) suggesting a fenestration. CT, computed tomography.
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Fig. 4 Axial oblique CT image showing the proximal segment of the left atrium (chevron) receiving blood from all four pulmonary veins. CT, computed tomography.


Publication History

Article published online:
06 October 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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