Congenitally divided left atrium: diagnostic pitfalls in cross-sectional echocardiography.
A 20-month-old patient with a previously diagnosed atrial septal defect presented with acute heart failure. The clinical and echocardiographic features at admission to hospital were of a congenitally partitioned left atrium. At surgery a medially displaced and infolded left atrial appendage together with infolded left atrial wall was found, which gave a false appearance of a left atrial 'membrane'. This unusual arrangement was subsequently correctly identified by transoesophageal echocardiography. It is speculated that the abnormal orientation of the appendage may have produced a physiologic and haemodynamic situation akin to anomalous drainage of the pulmonary veins, which would account for the clinical features in this patient.
Sadiq
M
M
Heart Unit, Children's Hospital, Birmingham, UK.
Sreeram
N
N
Silove
E D
ED
D003310:Cor Triatriatum / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007223:Infant; D008297:Male