A Patient with Ostium Secundum Type of Atrial Septal Defect Who Has Shown Specific Hemodynamics Diagnosed by Transesophageal Echocardiography

Abstract

A 65-year-old woman was referred to our hospital because of ECG abnormalities that were observed during a health check up. Physical examination revealed a systolic murmur and fixed splitting of the second heart sound at the left sternal border in the second intercostal space. ECG revealed sinus rhythm and complete right bundle branch block. Chest X-ray revealed no cardiomegaly and no dilatation of the pulmonary arteries. Transthoracic echocardiography (TTE) showed no apparent abnormalities except for mild pulmonary stenosis. Transesophageal echocardiography (TEE) revealed an oval ostium secundum type of atrial septal defect (ASD) with a diameter of approximately 3 cm and minor LA → RA shunt. Cardiac catheterization data have supported this finding. Minor pulmonary stenosis and an oval morphology of atrial septal defect may have resulted in some specific hemodynamics in this case.