title: Atrial septal defect with right-to-left shunt in the absence of pulmonary hypertension.
abstract: We describe the case of a 27-year-old gentleman who developed late-onset clubbing and cyanosis. Transoesophageal echocardiography revealed a 27-mm ostium secundum atrial septal defect and a large, floppy Eustachian valve directing right atrial blood to the left side of the heart.
authors.affiliation: Department of Cardiology,Christian Medical College and Hospital,Vellore,India.
authors.forename: Devi A
authors.initials: DA
authors.lastname: Manuel
authors.affiliation: Department of Cardiology,Christian Medical College and Hospital,Vellore,India.
authors.forename: Gopal C
authors.initials: GC
authors.lastname: Ghosh
authors.affiliation: Department of Cardiology,Christian Medical College and Hospital,Vellore,India.
authors.forename: Anoop G
authors.initials: AG
authors.lastname: Alex
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017548:Echocardiography, Transesophageal; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary; D008297:Male
keywords: Clubbing; cyanosis; prominent Eustachian valve