[Cor triatriatum in adulthood: Doppler echocardiographic diagnosis. Case report of an asymptomatic adult].

Cor triatriatum is a rare cardiac malformation occurring in about 0.1% of all congenital heart disease. As symptoms are usually present soon after birth, diagnosis in adulthood is extremely rare. We describe a case of a 33-year-old asymptomatic woman who was referred for echocardiographic examination because of a postural variable systolic click. The anatomy of the malformation and the hemodynamics of the left atrium were accurately assessed by means of conventional transthoracic Doppler echocardiography. The antero-inferior course of the intraatrial membrane inserting proximal to the left atrial appendage was documented in multiple perpendicular planes of examination. All pulmonary veins drained correctly into the proximal compartment of the left atrium. Additionally, a small atrial septal defect communicated between the distal compartment of the left atrium and the right atrium. Using pulsed wave Doppler, no site of pressure gradient could be detected between the two compartments of the left atrium. Thus, conventional transthoracic Doppler echocardiography represents an adequate tool for assessing cor triatriatum in adults. The patient refused transesophageal echocardiography.