A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood

Amanuel Dagabas Wakoya; Ayto Addisu Negash; Zebideru Alayuu Abebe; Fitsum Negusse Assefa; Zelalem Getahun; Alemu Bimrew Mesekere

doi:doi:10.11648/j.ijcems.20251102.12

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A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood

Amanuel Dagabas Wakoya^*

, Ayto Addisu Negash

, Zebideru Alayuu Abebe

, Fitsum Negusse Assefa

, Zelalem Getahun

, Alemu Bimrew Mesekere

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 11, Issue 2)

Received: 28 June 2025 Accepted: 23 July 2025 Published: 11 August 2025

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Abstract

Background: Cor-triatriatum is a rare congenital cardiac anomaly characterized by a fibromuscular membrane that divides the left atrium into two chambers, giving the appearance of three atrial compartments. It typically presents during infancy or childhood due to obstructive symptoms but may remain undiagnosed until adulthood in milder or non-obstructive cases. Case Presentation: A 33-year-old Ethiopian male with no known past medical history presented with a one-month history of progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and bilateral leg swelling. He also reported a productive cough, pleuritic chest pain, and high-grade intermittent fever of similar duration. Physical examination and initial investigations suggested decompensated heart failure and pneumonia. Transthoracic echocardiography revealed findings consistent with cor-triatriatum sinister. Despite initiation of supportive care, intravenous antibiotics, diuretics, and mechanical ventilation, the patient’s condition deteriorated. He ultimately developed cardiogenic shock and died during hospitalization. Conclusion: Cor-triatriatum is a rare but important cause of heart failure in adult patients. This case demonstrates that congenital heart disease can remain clinically silent for decades and may present with acute decompensation. Awareness and early recognition of this anomaly, especially in resource-limited settings, are essential for timely diagnosis and management. Point-of-care ultrasound can be a valuable tool in such environments for rapid cardiac assessment and should be considered when evaluating patients with unexplained heart failure symptoms.

Published in	International Journal of Clinical and Experimental Medical Sciences (Volume 11, Issue 2)
DOI	10.11648/j.ijcems.20251102.12
Page(s)	23-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Atypical Cor Triatriatum Sinister, Heart Failure, Young Adult, Case Report

References

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[2]	S. R. Lindauer, Incidental finding of cor triatriatum sinistrum in an adult, Journal of Diagnostic Medical Sonography 30 (2014) 332-336. https://doi.org/10.1177/8756479314545774
[3]	E. Ilhan, M. Ergelen, Ö. Soylu, R. Tosu, T. S. Güvenç, Ş. Kul, T. Tezel, Severe right heart failure and pulmonary hypertension because of cor triatriatum sinister in a 54 year-old patient, Int J Cardiol 151 (2011). https://doi.org/10.1016/j.ijcard.2010.04.071
[4]	S. Medellin, N. Burbano-Vera, A. Alfirevic, Obstructed Supramitral Inflow: Cor Triatriatum Sinister Presentation in Adulthood, J Cardiothorac Vasc Anesth 38 (2024) 576-580. https://doi.org/10.1053/j.jvca.2023.11.006
[5]	S A DOXIADIS, & J L EMERY. (1953). A case of triatrial heart. The Journal of Pediatrics, 42(1), 87-91. https://doi.org/10.1016/s0022-3476(53)80114-9
[6]	L. B. Mcguire, T. B. Nolan, R. Reeve, J. F. Dammann, Cor Triatriatum as a Problem of Adult Heart Disease, 1965. http://ahajournals.org
[7]	O. Işik, M. Akyüz, M. F. Ayik, E. Levent, Y. Atay, Cor triatriatum sinister: A case series, Turk Kardiyoloji Dernegi Arsivi 44 (2016) 20-23. https://doi.org/10.5543/tkda.2015.04780
[8]	N. Alphonso, M. A. Nørgaard, A. Newcomb, Y. D’Udekem, C. P. Brizard, A. Cochrane, Cor triatriatum: Presentation, diagnosis and long-term surgical results, Annals of Thoracic Surgery 80 (2005) 1666-1671. https://doi.org/10.1016/j.athoracsur.2005.04.055
[9]	N. Nawaz, A. Jones, ATRIAL FIBRILLATION COMPLEX CASE STUDY Cor Triatriatum Sinister in an 88-year-old Male with New-onset Atrial Fibrillation, (n. d.). https://doi.org/10.19102/icrm.2015.060502
[10]	R. Hamdan, N. Mirochnik, D. Celermajer, P. Nassar, L. Iserin, Cor Triatriatum Sinister diagnosed in adult life with three dimensional transesophageal echocardiography., BMC Cardiovasc Disord 10 (2010) 54. https://doi.org/10.1186/1471-2261-10-54
[11]	M. S. Tsai, W. J. Chen, C. H. Huang, Cor Triatriatum in an adult with late presentation of symptoms, J Med Ultrasound 21 (2013) 156-158. https://doi.org/10.1016/j.jmu.2013.07.005
[12]	J. Kokotsakis, V. Anagnostakou, G. Almpanis, I. Paralikas, I. Nenekidis, T. Kratimenos, E. Prapa, N. Tragotsalou, A. Lioulias, A. Mazarakis, Cor triatriatum presenting as heart failure with reduced ejection fraction: A case report, J Cardiothorac Surg 6 (2011). https://doi.org/10.1186/1749-8090-6-83
[13]	A. Thakrar, M. D. Shapiro, D. S. Jassal, T. G. Neilan, M. Etta, E. King, S. Abbara, Cor triatriatum: The utility of cardiovascular imaging, 2007.
[14]	E. Einav, G. Perk, I. Kronzon, Three-dimensional transthoracic echocardiographic evaluation of cor triatriatum, European Journal of Echocardiography 9 (2008) 110-112. https://doi.org/10.1016/j.euje.2007.02.002
[15]	L. Di Bacco, M. D’Alonzo, A. Repossini, F. Zanin, C. Muneretto, S. Benussi, Treatment of non-restrictive cor triatriatum sinister during concomitant cardiac surgery, The Cardiothoracic Surgeon 30 (2022). https://doi.org/10.1186/s43057-022-00076-5

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APA Style

Wakoya, A. D., Negash, A. A., Abebe, Z. A., Assefa, F. N., Getahun, Z., et al. (2025). A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. International Journal of Clinical and Experimental Medical Sciences, 11(2), 23-27. https://doi.org/10.11648/j.ijcems.20251102.12

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ACS Style

Wakoya, A. D.; Negash, A. A.; Abebe, Z. A.; Assefa, F. N.; Getahun, Z., et al. A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. Int. J. Clin. Exp. Med. Sci. 2025, 11(2), 23-27. doi: 10.11648/j.ijcems.20251102.12

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AMA Style

Wakoya AD, Negash AA, Abebe ZA, Assefa FN, Getahun Z, et al. A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. Int J Clin Exp Med Sci. 2025;11(2):23-27. doi: 10.11648/j.ijcems.20251102.12

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@article{10.11648/j.ijcems.20251102.12,
  author = {Amanuel Dagabas Wakoya and Ayto Addisu Negash and Zebideru Alayuu Abebe and Fitsum Negusse Assefa and Zelalem Getahun and Alemu Bimrew Mesekere},
  title = {A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood
},
  journal = {International Journal of Clinical and Experimental Medical Sciences},
  volume = {11},
  number = {2},
  pages = {23-27},
  doi = {10.11648/j.ijcems.20251102.12},
  url = {https://doi.org/10.11648/j.ijcems.20251102.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20251102.12},
  abstract = {Background: Cor-triatriatum is a rare congenital cardiac anomaly characterized by a fibromuscular membrane that divides the left atrium into two chambers, giving the appearance of three atrial compartments. It typically presents during infancy or childhood due to obstructive symptoms but may remain undiagnosed until adulthood in milder or non-obstructive cases. Case Presentation: A 33-year-old Ethiopian male with no known past medical history presented with a one-month history of progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and bilateral leg swelling. He also reported a productive cough, pleuritic chest pain, and high-grade intermittent fever of similar duration. Physical examination and initial investigations suggested decompensated heart failure and pneumonia. Transthoracic echocardiography revealed findings consistent with cor-triatriatum sinister. Despite initiation of supportive care, intravenous antibiotics, diuretics, and mechanical ventilation, the patient’s condition deteriorated. He ultimately developed cardiogenic shock and died during hospitalization. Conclusion: Cor-triatriatum is a rare but important cause of heart failure in adult patients. This case demonstrates that congenital heart disease can remain clinically silent for decades and may present with acute decompensation. Awareness and early recognition of this anomaly, especially in resource-limited settings, are essential for timely diagnosis and management. Point-of-care ultrasound can be a valuable tool in such environments for rapid cardiac assessment and should be considered when evaluating patients with unexplained heart failure symptoms.},
 year = {2025}
}

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TY  - JOUR
T1  - A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood

AU  - Amanuel Dagabas Wakoya
AU  - Ayto Addisu Negash
AU  - Zebideru Alayuu Abebe
AU  - Fitsum Negusse Assefa
AU  - Zelalem Getahun
AU  - Alemu Bimrew Mesekere
Y1  - 2025/08/11
PY  - 2025
N1  - https://doi.org/10.11648/j.ijcems.20251102.12
DO  - 10.11648/j.ijcems.20251102.12
T2  - International Journal of Clinical and Experimental Medical Sciences
JF  - International Journal of Clinical and Experimental Medical Sciences
JO  - International Journal of Clinical and Experimental Medical Sciences
SP  - 23
EP  - 27
PB  - Science Publishing Group
SN  - 2469-8032
UR  - https://doi.org/10.11648/j.ijcems.20251102.12
AB  - Background: Cor-triatriatum is a rare congenital cardiac anomaly characterized by a fibromuscular membrane that divides the left atrium into two chambers, giving the appearance of three atrial compartments. It typically presents during infancy or childhood due to obstructive symptoms but may remain undiagnosed until adulthood in milder or non-obstructive cases. Case Presentation: A 33-year-old Ethiopian male with no known past medical history presented with a one-month history of progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and bilateral leg swelling. He also reported a productive cough, pleuritic chest pain, and high-grade intermittent fever of similar duration. Physical examination and initial investigations suggested decompensated heart failure and pneumonia. Transthoracic echocardiography revealed findings consistent with cor-triatriatum sinister. Despite initiation of supportive care, intravenous antibiotics, diuretics, and mechanical ventilation, the patient’s condition deteriorated. He ultimately developed cardiogenic shock and died during hospitalization. Conclusion: Cor-triatriatum is a rare but important cause of heart failure in adult patients. This case demonstrates that congenital heart disease can remain clinically silent for decades and may present with acute decompensation. Awareness and early recognition of this anomaly, especially in resource-limited settings, are essential for timely diagnosis and management. Point-of-care ultrasound can be a valuable tool in such environments for rapid cardiac assessment and should be considered when evaluating patients with unexplained heart failure symptoms.
VL  - 11
IS  - 2
ER  -

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Author Information

Amanuel Dagabas Wakoya

Department of Emergency and Critical Care Medicine, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0009-0008-2567-6417
Ayto Addisu Negash

Department of Emergency and Critical Care Medicine, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0009-0008-7916-779X
Zebideru Alayuu Abebe

Department of Emergency and Critical Care Medicine, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0009-0005-1657-0272
Fitsum Negusse Assefa

Department of Internal Medicine, Cardiology Division, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0009-0004-7519-1523
Zelalem Getahun

Department of Intensive Care Unit, St paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0000-0002-7503-3435
Alemu Bimrew Mesekere

Department of Emergency and Critical Care Medicine, Addis Ababa University, Addis Ababa, Ethiopia

Contact Email

http://orcid.org/0009-0001-1951-105X

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APA Style

Wakoya, A. D., Negash, A. A., Abebe, Z. A., Assefa, F. N., Getahun, Z., et al. (2025). A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. International Journal of Clinical and Experimental Medical Sciences, 11(2), 23-27. https://doi.org/10.11648/j.ijcems.20251102.12

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ACS Style

Wakoya, A. D.; Negash, A. A.; Abebe, Z. A.; Assefa, F. N.; Getahun, Z., et al. A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. Int. J. Clin. Exp. Med. Sci. 2025, 11(2), 23-27. doi: 10.11648/j.ijcems.20251102.12

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AMA Style

Wakoya AD, Negash AA, Abebe ZA, Assefa FN, Getahun Z, et al. A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood. Int J Clin Exp Med Sci. 2025;11(2):23-27. doi: 10.11648/j.ijcems.20251102.12

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@article{10.11648/j.ijcems.20251102.12,
  author = {Amanuel Dagabas Wakoya and Ayto Addisu Negash and Zebideru Alayuu Abebe and Fitsum Negusse Assefa and Zelalem Getahun and Alemu Bimrew Mesekere},
  title = {A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood
},
  journal = {International Journal of Clinical and Experimental Medical Sciences},
  volume = {11},
  number = {2},
  pages = {23-27},
  doi = {10.11648/j.ijcems.20251102.12},
  url = {https://doi.org/10.11648/j.ijcems.20251102.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20251102.12},
  abstract = {Background: Cor-triatriatum is a rare congenital cardiac anomaly characterized by a fibromuscular membrane that divides the left atrium into two chambers, giving the appearance of three atrial compartments. It typically presents during infancy or childhood due to obstructive symptoms but may remain undiagnosed until adulthood in milder or non-obstructive cases. Case Presentation: A 33-year-old Ethiopian male with no known past medical history presented with a one-month history of progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and bilateral leg swelling. He also reported a productive cough, pleuritic chest pain, and high-grade intermittent fever of similar duration. Physical examination and initial investigations suggested decompensated heart failure and pneumonia. Transthoracic echocardiography revealed findings consistent with cor-triatriatum sinister. Despite initiation of supportive care, intravenous antibiotics, diuretics, and mechanical ventilation, the patient’s condition deteriorated. He ultimately developed cardiogenic shock and died during hospitalization. Conclusion: Cor-triatriatum is a rare but important cause of heart failure in adult patients. This case demonstrates that congenital heart disease can remain clinically silent for decades and may present with acute decompensation. Awareness and early recognition of this anomaly, especially in resource-limited settings, are essential for timely diagnosis and management. Point-of-care ultrasound can be a valuable tool in such environments for rapid cardiac assessment and should be considered when evaluating patients with unexplained heart failure symptoms.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - A Case of Atypical Cor Triatriatum Sinister Persisting into Adulthood

AU  - Amanuel Dagabas Wakoya
AU  - Ayto Addisu Negash
AU  - Zebideru Alayuu Abebe
AU  - Fitsum Negusse Assefa
AU  - Zelalem Getahun
AU  - Alemu Bimrew Mesekere
Y1  - 2025/08/11
PY  - 2025
N1  - https://doi.org/10.11648/j.ijcems.20251102.12
DO  - 10.11648/j.ijcems.20251102.12
T2  - International Journal of Clinical and Experimental Medical Sciences
JF  - International Journal of Clinical and Experimental Medical Sciences
JO  - International Journal of Clinical and Experimental Medical Sciences
SP  - 23
EP  - 27
PB  - Science Publishing Group
SN  - 2469-8032
UR  - https://doi.org/10.11648/j.ijcems.20251102.12
AB  - Background: Cor-triatriatum is a rare congenital cardiac anomaly characterized by a fibromuscular membrane that divides the left atrium into two chambers, giving the appearance of three atrial compartments. It typically presents during infancy or childhood due to obstructive symptoms but may remain undiagnosed until adulthood in milder or non-obstructive cases. Case Presentation: A 33-year-old Ethiopian male with no known past medical history presented with a one-month history of progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and bilateral leg swelling. He also reported a productive cough, pleuritic chest pain, and high-grade intermittent fever of similar duration. Physical examination and initial investigations suggested decompensated heart failure and pneumonia. Transthoracic echocardiography revealed findings consistent with cor-triatriatum sinister. Despite initiation of supportive care, intravenous antibiotics, diuretics, and mechanical ventilation, the patient’s condition deteriorated. He ultimately developed cardiogenic shock and died during hospitalization. Conclusion: Cor-triatriatum is a rare but important cause of heart failure in adult patients. This case demonstrates that congenital heart disease can remain clinically silent for decades and may present with acute decompensation. Awareness and early recognition of this anomaly, especially in resource-limited settings, are essential for timely diagnosis and management. Point-of-care ultrasound can be a valuable tool in such environments for rapid cardiac assessment and should be considered when evaluating patients with unexplained heart failure symptoms.
VL  - 11
IS  - 2
ER  -

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