Cor triatriatum echocardiography


 * Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Echocardiography is the preferred method to diagnose a divided atrium. The transthoracic two dimensional echocardiography is usually aided by transesophageal echocardiogram for further evaluation. MRI provides a better spatial resolution and tissue contrast as compared to echocardiogram. MRI is said to have higher sensitivity than echocardiogram and angiography.

As an evaluative tool, echocardiograms can identify functionality issues within the heart's anatomy. The function of identifying a cor triatriatum defect is to identify the diaphragm dividing the left atrial chambers and the presence of associated defects.

Echocardiography
Echocardiography is the diagnostic imaging modality of choice and easily identifies atrial morphology such as diaphragm dividing the left atrial chambers and can also identify the presence of an associated atrial septal defect. It is also very important to identify the origin of each of the pulmonary veins to exclude the presence of anomalous pulmonary venous return which may coexist with the disorder. Cor triatriatum may indeed be difficult to distinguish from a total anomalous pulmonary venous connection to the coronary sinus.



Echocardiographic differentiation between cor triatriatum and supravalvular mitral ring:
A cor triatriatum membrane tends to:
 * 1) Be more curved.
 * 2) Moves toward the mitral valve plane in diastole
 * 3) All pulmonary veins drain proximal to the membrane
 * 4) The left atrial appendage and the foramen ovale are distal to the membrane

A supramitral ring tends to:
 * 1) Attach to the base of the mitral valve past the left atrial appendage and past the foramen ovale
 * 2) Move away from the mitral valve in diastole
 * 3) Be associated with abnormal mitral leaflet motion and a prolonged Doppler pressure half time