View source for Cor triatriatum

==Background==
[[File:Cor triatriatum.jpg|thumb|XC: anomalous upper chamber]]
*Congenital anomaly: heart with three atria<ref>Jha AK, Makhija N. Cor Triatriatum: A Review. Semin Cardiothorac Vasc Anesth. 2017 Jun;21(2):178-185. PMID 27913770</ref>
*Either LA or RA can be divided into 2 compartments (cor triatriatum sinistrum or cor triatriatum dextrum)
*Can be associated with other congenital syndromes including [[tetralogy of Fallot]], double outlet RV, [[coarctation of the aorta]], [[VSD]], AV septal defect
*0.1-0.4% incidence in USA

==Clinical Features==
*Sinistrum variant most associated with other congenital cardiovascular defects in symptomatic infants
*Can be incidental finding in adults as either isolated finding or in association with PFO, ASD, persistent left superior vena cava
*Symptoms depend on size of opening in accessory membrane between the atria
*Symptoms include [[dyspnea]] on exertion, orthopnea, easy fatiguability, low exercise tolerance, [[palpitations]]
*Increased risk of thrombus formation in LA
*[[Murmur]]
*Elevated JVD
*[[Hepatomegaly]]
*[[Ascites]]
*Peripheral edema

==Differential Diagnosis==
*[[Pericarditis]]
*[[Pulmonary Hypertension]]
*Right [[heart failure]]
*Atrial Myxoma
*[[Mitral Stenosis]]
*Tricuspid Stenosis

{{Congenital heart disease DDX}}

==Evaluation==
*Initial workup may include:
**[[ECG]]: Atrial premature complexes, Left or Right atrial abnormalities, Right axis deviation, Right heart strain
**[[CXR]]
**[[Echocardiography]]
**Right heart cath

==Management==
*As associated with major cyanotic or acyanotic congenital heart lesions, mortality can be up to 75% in untreated symptomatic infants
*Treat increased pulmonary vascular resistance, [[heart failure]]
*Inotropic agents (eg, [[dopamine]], [[dobutamine]]), [[diuretics]]
*Manage [[hypoxia]], fluid status, rate in [[afib]]
*[[DVT]]/PE prophylaxis
**Cardiac surgery consultation

==Disposition==

==See Also==
*[[Congenital heart disease]]

==External Links==

==References==
<references/>

[[Category:Pediatrics]]
[[Category:Cardiology]]