SINUS VENOUS ATRIAL SEPTAL DEFECT: TTE CHALLENGING DIAGNOSIS

Introduction: The atrial septal defects are the most common congenital heart diseases moreover the Sinus venous atrial septal defect (SVD) is a rare cardiac abnormality, particularly difficult to diagnose. It is commonly associated anomalous with anomalous pulmonary venous return. The conventional treatment is Surgery. Case report: We report a case of a 61 year old man with medical history only significant for diabetes mellitus. He undergone a chest X rays for his annual medical examination which showed a cardiomegaly A transthoracic echocardiographies (TTE) examination done previously in other centers showed a dilated right heart chambers with a moderate pulmonary hypertension, but did not show any ASD. He was referred for a dilated right chambers misdiagnosed as a pulmonary hypertension. The TTE revealed a Sinus venosus atrial septal (SVASD) defect seen in the sub costal view. TEE confirmed the diagnosis showing a large SVASD of 20 mm with left-right shunt (Qp/Qs 2, 05). Conclusion: The diagnosis of SVASD is difficult and requires special imaging. But when there is any suspicion of ASD, especially with patients who have unexplained dilated right ventricle and a pulmonary hypertension, the sub-costal view on the TTE can be useful.