Atypical Atrial Flutter Unveiling Cor Triatriatum Sinister in a Stable Adult
Abstract
Background: Cor triatriatum sinister (CTS) is a rare congenital anomaly, infrequently identified in asymptomatic adults.
Case summary: A 64-year-old man presented with asymptomatic atrial flutter detected on routine electrocardiogram. Rate control was suboptimal, and because of unknown arrhythmia duration, transesophageal echocardiography (TEE) was performed before cardioversion. TEE excluded intracardiac thrombus and incidentally revealed a left atrial membrane. Cardiac magnetic resonance imaging confirmed nonobstructive CTS. The patient underwent successful TEE-guided electrical cardioversion and was discharged on anticoagulation.
Discussion: CTS has been associated with atrial arrhythmia, although causality remains uncertain, particularly when arrhythmia originates from the right atrium. This case highlights the role of multimodality imaging in identifying incidental congenital anomalies and guiding safe management.
Take-home messages: Careful atrial evaluation during TEE may reveal incidental CTS. Distinguishing associations from causation is essential for appropriate management.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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