SHM Converge Scientific Abstract ePoster Gallery-Sinus Venosus Asd - A Concealed Etiology of Pulmonary Hypertension

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This case highlights the importance of recognizing atrial septal defect (ASD) in adults who present with right atrial and right ventricular enlargement and reduced systolic function. While ostium secundum and ostium primum ASDs are usually well assessed by transthoracic echocardiography (TTE), sinus venosus defects are much harder to detect because of their posterior location. As a result, TTE may miss these lesions, with reported detection rates as low as 12%.  <br /><br />Transesophageal echocardiography (TEE) should therefore be pursued when sinus venosus ASD is suspected, as it provides better visualization and can also identify associated partial anomalous pulmonary venous return, which commonly accompanies superior sinus venosus defects.  <br /><br />The discussion emphasizes that ASDs are often asymptomatic until adulthood, so clinicians should consider them in patients with unexplained right-sided chamber enlargement. Early diagnosis is important because unrepaired defects in older patients can progress to severe pulmonary hypertension and shunt reversal, leading to Eisenmenger syndrome, at which point surgical repair is no longer appropriate.

Asset Subtitle

Paulus Adinugraha

Meta Tag

Author List Alvaro Vargas Pelaez, Logan Bernhardt, Maria Riasat, Paulus Adinugraha, Syed Ibrahim Rashid, Tatyana Danilov

Category Clinical Vignettes

Concept Atrial Septal Defect

Concept Atrial Dilation

Concept Right Ventricular Dilation

Concept Transthoracic Echocardiography

Concept Sinus Venosus Defect

Distinguished Non-Finalist

Presenter Organization Mount Sinai Beth Israel Hospital

Presenting Author Paulus Adinugraha

Track Adult

Keywords

atrial septal defect

ASD

sinus venosus defect

transthoracic echocardiography

transesophageal echocardiography

right atrial enlargement

right ventricular enlargement

partial anomalous pulmonary venous return

pulmonary hypertension

Eisenmenger syndrome

Atrial Septal Defect

Atrial Dilation

Right Ventricular Dilation

Transthoracic Echocardiography

Sinus Venosus Defect