A 26-year-old obese woman presented with progressive exertional dyspnea and cyanosis. Visualization of the heart by transthoracic echocardiography was suboptimal; therefore, transesophageal echocardiography was performed. This revealed a complete lack of any atrial septal tissue (single atrium). The right ventricle was enlarged. Mitral and tricuspid valve attachments to the interventricular septum were in the same anatomic plane, but a cleft mitral valve was not present.
The patient was referred for surgery, and a pericardial patch was used successfully to create an interatrial septum.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
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