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Case Reports
. 2019 Oct 17;11(10):e5936.
doi: 10.7759/cureus.5936.

Sinus Venosus Atrial Septal Defect: A Challenging Diagnosis

Ziga Vodusek  1 , Shehryar Khaliqdina  2 , Carolina Borz-Baba  3 , Rebecca Scandrett  4
Affiliations
Case Reports

Sinus Venosus Atrial Septal Defect: A Challenging Diagnosis

Ziga Vodusek et al. Cureus. .

Abstract

Sinus venosus atrial septal defect (SVASD) is a rare adult congenital heart disease which permits shunting of blood from the systemic to the pulmonary circulation and is commonly associated with anomalous pulmonary venous return. We report a case of a 27-year-old man with a history of premature birth and unilateral cryptorchidism who was admitted for syncope. Electrocardiogram (ECG) demonstrated atrial fibrillation (AF)and S1Q3T3 pattern along with an incomplete right bundle branch block. Transthoracic echocardiography (TTE) suggested the presence of right ventricular pressure and volume overload and severe right ventricular and right atrial enlargement. The agitated saline study was negative suggesting no inter-atrial communication. Transesophageal echocardiography (TEE) demonstrated a superior SVASD and raised the possibility of an anomalous pulmonary venous connection. Chest computed tomography identified the right superior pulmonary vein connection to the superior vena cava. The diagnosis of SVASD poses multiple challenges from the variety of symptoms to the selection of appropriate imaging and the complexity of surgical treatment.

Keywords: anomalous pulmonary venous connection; atrial fibrillation; atrial septal defect (asd); echocardiogram; syncope; trans-esophageal echocardiography; trans-thoracic echocardiography.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Transesophageal echocardiography
The arrow shows superior sinus venosus atrial septal defect. LA, left atrium; SVC, superior vena cava; RA, right atrium
Figure 2
Figure 2. Transesophageal echocardiography with Doppler
The arrow shows left-to-right shunting. LA, left atrium; SVC, superior vena cava; RA, right atrium
Figure 3
Figure 3. Computed tomography angiography
Right superior pulmonary vein (arrowhead) connection to superior vena cava (arrow).
See this image and copyright information in PMC

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