Echocardiographic diagnosis of flail anterior leaflet in tricuspid endocarditis.

as the rest of the fingers.5 Additionally, the thumb may be triphalanged, absent, or simply longer than normal in association with a short forearm which displays limited supination and pronation. All these upper extremity features are combined with an ostium secundum atrial septal defect, thereby completing the salient anatomy of the condition. The patient under current investigation did not have anomalies of the thumb or an ostium secundum atrial septal defect. We propose that the association of Poland’s syndrome with an atrial septal defect is not merely a chance phenomenon. It is likely that there is a wide spectrum of upper limb and torso developmental variations which are linked to defects in the atrial septum. This thesis is compatible with the mesenchymal disturbance which has been invoked to explain both Poland and Holt-Oram syndromes. Careful investigation for atria1 septal defect in those patients affected with Poland’s syndrome would appear warranted.