[An unexpected case of right heart dilation in the elderly].

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Giornale italiano di cardiologia Pub Date : 2023-10-01 DOI:10.1714/4100.40984
Michele Pagliaccia, Serenella Conti, Alessandro Bufi, Valentino Borghetti, Marcella De Paolis, Marcello Dominici
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Abstract

Atrial septal defects (ASD) represent the most common congenital heart defect diagnosed in adulthood. Adults with an ASD are often asymptomatic, but sometimes may present with non-specific symptoms such as dyspnea on exertion or exercise intolerance. Isolated sinus venosus atrial defect is an extremely rare anomaly. Sinus venosus defects occur more commonly in the superior (rather than inferior) portion of the embryologic sinus venosus and commonly occur with partial anomalous pulmonary venous return, particularly of the right upper pulmonary vein. We describe the case of an 80-year-old man with an undiagnosed, hemodynamically significant superior sinus venosus type of ASD who presented with persistent dyspnea and hypoxia after COVID-19 disease. Although cardiac magnetic resonance represents the gold standard for the morpho-functional evaluation of ASDs, transesophageal echocardiography is an accessible method for diagnosing the superior sinus venosus type of ASD and three-dimensional transesophageal echocardiography is useful for obtaining an "en face" view of the ASD and important surrounding structures.

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[一例意外的老年人右心扩张病例]。
房间隔缺损(ASD)是成年后诊断出的最常见的先天性心脏缺陷。患有ASD的成年人通常没有症状,但有时可能出现非特异性症状,如运动时呼吸困难或运动不耐受。孤立性静脉窦性心房缺损是一种极为罕见的异常。静脉窦缺损更常见于胚胎性静脉窦的上部(而非下部),通常发生在部分肺静脉回流异常,尤其是右上肺静脉。我们描述了一例80岁男性,患有未诊断的、血液动力学显著的上窦静脉型ASD,在新冠肺炎疾病后表现为持续呼吸困难和缺氧。尽管心脏磁共振是ASD形态功能评估的金标准,但经食管超声心动图是诊断静脉窦上型ASD的一种可行方法,三维经食管超声检查有助于获得ASD和重要周围结构的“正面”视图。
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Giornale italiano di cardiologia
Giornale italiano di cardiologia CARDIAC & CARDIOVASCULAR SYSTEMS-
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