PULMONARY PUZZLE
ANSWER
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From the question on page 580
The MRI shows cor triatriatum (fig 1). This is a rare congenital abnormality accounting for 0.1% of all congenital cardiac malformations.1 It is caused by a failure of common pulmonary vein resorption during cardiogenesis. This leads to persistence of a diaphragm-like membrane dividing the left atrium. Communication between the chambers is via one or more orifices. The size of this communication determines the degree of obstruction to pulmonary venous return. Elevation in pulmonary venous pressure and pulmonary vascular resistance may cause pulmonary hypertension (PHT).2 As in this case, echocardiography may not reveal the left atrial membrane.
Figure 1 MRI showing cor triatriatum. AC, antechamber; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
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Normal pregnancy is characterised by a 45–50% increase in blood volume and cardiac output and a reduction in vascular resistance.3 In pulmonary arterial hypertension (PAH), which is an
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Thorax 2009 64: 580.[Extract] [Full Text] [PDF]
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