Cor triatriatum in a young woman with syncope.

1 of 3 DESCRIPTION A 28-year-old woman presented with recurrent syncope, usually precipitated by anxiety. On examination, she had a low blood pressure of 112/72 mm Hg with normal heart sounds and showed no features suggestive of genetic abnormalities. ECG, Holter and treadmill stress tests were normal. Transthoracic ( fi gure 1 ) and transoesophageal ( fi gure 2 ) echocardiography demonstrated non-obstructive cor triatriatum. A diagnosis of vasovagal syncope with incidental cor triatriatum was made. Cor triatriatum consists of a fi bromuscular membrane dividing the left atrium into a posterosuperior chamber receiving blood from the pulmonary veins and an anteroinferior chamber containing the left-atrial appendage and mitral orifi ce. It represents 0.4% of congenital cardiac anomalies, 1 and is associated with other cardiac defects in 70–80% of cases, 2 anomalous pulmonary venous drainage being the most common. Echocardiography is crucial to determine the transmembrane gradient, pulmonary vein drainage and associated defects. 1 Images in...