"Asthma": an unusual presentation of cor triatriatum.

Published on Jan 1, 2007in Hellenic Journal of Cardiology4.047
Shishir Karthik8
Estimated H-index: 8
(LGI: Leeds General Infirmary),
Timotheos G. Kelpis5
Estimated H-index: 5
+ 1 AuthorsNihal A. Weerasena1
Estimated H-index: 1
Sources
Abstract
: We discuss an extremely unusual presentation of a 19-month-old child with cor triatriatum and an intact interatrial septum, who presented for the first time at the age of 16 months with wheezing and repeated lower respiratory tract infections. At surgery, a thick fibromuscular membrane with a 2-3 mm eccentrically placed orifice was identified, and following surgical resection of the membrane the child made an uneventful recovery. This case demonstrates the need for investigating children with "asthma" who do not respond to conventional medical management. A rare but potentially correctable underlying cause may be found.
References5
Newest
#1Ryszard W. Lupinski (Boston Children's Hospital)H-Index: 2
#2Sriram ShankarH-Index: 4
Last. Jacek J MollH-Index: 1
view all 6 authors...
From 1985 to 1999, 18 patients with cor triatriatum underwent surgical correction.Their ages ranged from 3 months to 9 years (mean, 32.5 months). Eight patientswere cyanosed; the other 10 presented with congestive heart failure. Recurrentchest infection was observed in 10 cases, and failure to thrive in 7. One patienthad isolated cor triatriatum, and 17 had an associated atrial septal defect. Otherassociated anomalies included patent ductus arteriosus, ventricular septal defect,and partial and t...
6 CitationsSource
Cardiac malformations involving low-pressure chambers (i.e., either of the atria) are more often diagnosed later in life than lesions that involve high-pressure systems such as ventricular septal defects or persistent ducti arteriosi. Patients with congenital heart disease involving the atria may present only symptoms suggesting lung disease. We report on a child with recurrent episodes of wheezing, which did not respond to albuterol nebulizations and intravenous corticosteroids; he was subseque...
10 CitationsSource
From November 1973 to January 1988, 15 patients with for triatriatum underwent surgical correction at the Department of Cardiac Surgery, Ospedali Riuniti, Bergamo, Italy. Their ages ranged from 15 days to 48 years. Eight patients (53%) were younger than age 1 year. Evidence of congestive heart failure was present in five infants, whereas three infants, three children, and two adults initially bad signs of pulmonary venous obstruction, and two children bad a heart murmur only. Five patients had c...
38 CitationsSource
#1James B. AreyH-Index: 1
#2B JamesH-Index: 1
Describes pediatric congenital and acquired diseases--both common and rare--of the heart and great vessels. Includes coverage of the embryologic development of the heart, methods employed at postmortem examinations, and the author's compiled data from more than 600 autopsies. Also features information on rheumatic fever; acquired diseases of the endocardium, myocardium, and pericardium; and vascular diseases and tumors of the heart and percardium. Superb illustrations highlight the various entit...
24 Citations
#1Jorge Oglietti (The Texas Heart Institute)H-Index: 6
#2Denton A. Cooley (The Texas Heart Institute)H-Index: 95
Last. George J. Reul (The Texas Heart Institute)H-Index: 38
view all 7 authors...
Abstract Twenty-five patients with cor triatriatum underwent surgical correction at the Texas Heart Institute during a 21-year period from 1959 to 1980. Patients ranged in age from 4 months to 38 years. Diagnosis was established preoperatively in 14 patients (56%), at the time of operation for correction of associated lesions in 10 patients (40%), and during reoperation in 1 (4%). In the earlier part of this series, diagnosis was more common at the time of operation. Associated cardiovascular an...
61 CitationsSource
Cited By5
Newest
#2Asalim Thabet (State University of New York Upstate Medical University)
Last. Tyler Greenfield (State University of New York Upstate Medical University)
view all 4 authors...
Author(s): Halfman, Camille; Thabet, Asalim; Blue, Rebecca; Greenfield, Tyler | Abstract: Cor triatriatum is a rare, congenital heart defect. When diagnosis does not occur in infancy, primary symptoms in an older patient may mimic reactive airway disease. We report a case of cor triatriatum in an older child, previously diagnosed with asthma, presenting to an emergency department with a chief complaint of wheezing. Initial treatment with bronchodilators and corticosteroids was unsuccessful, prom...
1 CitationsSource
#1Meng-Luen LeeH-Index: 1
#2Ying-Cheng ChenH-Index: 1
Last. Jien-Wen ChienH-Index: 1
view all 4 authors...
Cardiac asthma or cardiac wheezing (CW) refers to a syndrome of dyspnea and wheezing that mimicks asthma clinically. Reported herein is the case of a 2-month-old boy who presented with refractory wheezing as a sign of cor triatriatum sinister (CTS) that culminated in overwhelming multiple organ failure in a short time. On the day of admission, oxygen saturation (SpO2) was 20 000 pg/mL. Two-dimensional echocardiography with Doppler showed CTS, which was complicated with severe pulmonary arterial ...
2 CitationsSource
#1L. Tischler (University of Bremen)H-Index: 1
#2Franz Petermann (University of Bremen)H-Index: 70
Source
Das Cor triatriatum sinistrum zeichnet sich durch die Unterteilung des linken Vorhofs in 2Kompartimente durch eine fibromuskulare Membran aus [5]. In das superior-posterior gelegene Kompartiment munden gewohnlich die Lungenvenen ein. Das inferior-anteriore Kompartiment weist uber die Mitralklappe eine Kommunikation mit dem linken Ventrikel auf. In etwa 80% der Falle liegen ein Vorhofseptumdefekt oder ein persistierendes Foramen ovale vor [9]. Als Atiologie des Cor triatriatum sinistrum ist eine ...
Source
: Cor triatriatum sinister (CTS) is an extremely rare congenital cardiac malformation characterized by the presence of a fibromuscular membrane subdividing the left atrium into two chambers. Although respiratory symptoms are often observed in patients with this anomaly, wheezing is an unusual clinical presentation. We report on a child, born and resident in the Brazilian Amazonia, with a history of recurrent episodes of 'asthma' who was subsequently found to have CTS. After successful surgical c...
3 CitationsSource