Contrast Transesophageal Echocardiography in Diagnosing Congenital Enlargement of the Right Atrium

Abstract

Congenital malformation of the right atrium or the coronary sinus is rare, and cases are clas sified into 1 of the following 4 categories: (1) congenital enlargement of right atrium, (2) single diverticulum, (3) multiple diverticula of the right atrium, and (4) diverticulum of the coronary sinus. This report presents a 63-year-old man with cardiomegaly and no chest symptoms. A chest radiograph revealed an enlarged cardiac silhouette with a prominent right heart border. Although a transesophageal echocardiography revealed marked enlargement of the right atrium, neither further anomaly nor massive regurgitation was observed. The systolic pulmonary artery pressure derived from the peak velocity of mild tricuspid regurgitation was 38 mm Hg. Secondary enlargement of the right atrium due to atrial septal defect or pulmonary venous connection anomaly was deemed negligible by use of transesophageal contrast echocardiography, and primary enlargement of the right atrium was confirmed. Trans esophageal echocardiography using ultrasound contrast was determined to be feasible for diagnosing congenital malformation of the right atrium.

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References

Binder TM , Rosenhek R. , Frank H., et al : Congenital malformations of the right atrium and the coronary sinus: An analysis based on 103 cases reported in the literature and two additional cases. Chest 117:1740-1748, 2000 .

Bailey CP : Surgery of the Heart. Philadelphia: Lea and Febiger, 1955, p 413.

Gayet C. , Pillot M. , Revel D., et al : Diverticulum of the right atrium. A case report and review of the literature . Arch Mal Coeur Vaiss 85:1479-1482, 1992 .

Tenckhoff L. , Stamm SJ , Beckwith JB : Sudden death in idiopathic (congenital) right atrial enlargement. Postmortem findings and review of cases. Circulation 40:227-235, 1969.

Sheldon WC , Johnson CD , Favaloro RG : Idiopathic enlargement of the right atrium: Report of four cases . Am J Cardiol 23:278-284, 1969.

Iga K. , Hori K. , Matsumura T., et al : Large left-to-right shunt through a small atrial septal defect produced by progressive aortic stenosis in the elderly—a case report. Jpn Circ J 58:148-150, 1994.

Lambertz H. , Schuhmacher U. , Tries HP, et al : Improvement of pulmonary venous flow Doppler signal after intravenous injection of Levovist. J Am Soc Echocardiogr 10:891-898, 1997.