title: Progressive dyspnea and signs of right heart dysfunction.
abstract: A 40-year-old woman was admitted due to dyspnea and fever. Transthoracic echocardiography revealed signs of right heart volume overload and vegetations on the tricuspid valve with insufficiency. Transesophageal echocardiography showed a sinus venosus defect (SVD) with significant left-to-right shunt. Computed tomography scanning was primarily performed to rule out pulmonary embolism; however, it showed interatrial communication. Due to the concomitant tricuspid insufficiency with additional volume overload, the diagnosis of SVD was more challenging. Usually, transthoracic echocardiography remains the initial diagnostic imaging modality; however, detection rates are very low. Therefore, further imaging is mandatory in unexplained substantial right heart dilatation.
authors.affiliation: Department of Cardiology, Pneumology, and Intensive Care Medicine, Klinikum Neuperlach, Städtisches Klinikum München GmbH, München, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Staubach
authors.affiliation: Department of Cardiology, Pneumology, and Intensive Care Medicine, Klinikum Neuperlach, Städtisches Klinikum München GmbH, München, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Strohm
authors.affiliation: Department of Cardiology, Pneumology, and Intensive Care Medicine, Klinikum Neuperlach, Städtisches Klinikum München GmbH, München, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Mudra
mesh_terms: D000328:Adult; D018450:Disease Progression; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000151:congenital / Q000175:diagnosis; D006801:Humans; D014057:Tomography, X-Ray Computed; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000175:diagnosis
keywords: congenital heart disease; echocardiography; left-to-right shunt; right heart dysfunction; sinus venosus defect; volume overload