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Awareness of a Rare Diagnosis: CIA of the Coronary Sinus (A Case Report)

Interatrial communication is a common congenital heart disease in adulthood. It is subdivided into four distinct groups based on location.
Coronary sinus type is the rarest one and represents less than 1% of interatrial septal defects. Its echocardiographic diagnosis can be difficult.
We report the case of a 27-year-old female patient, admitted to the emergency department for management of a poorly tolerated supraventricular tachycardia, referred to cardiology after cardioversion.
Clinical examination revealed a SaO2 of 95%, a B2 burst at the pulmonary site. The ECG in sinus rhythm showed right bundle branch block and right atrial hypertrophy.
Echocardiography showed dilated right chambers, coronary sinus atrial septal defect with a left-to-right shunt, dysplastic mitral valve, and pulmonary pression was estimated at 85mmhg on tricuspid insufficiency flow; right ventricular function was normal.
The patient was treated with B-blocker and VKA with a good clinical course.
She is waiting a right catheterization to decide on surgical closure of the atrial septal defect.
Through this case, we wanted to underline the importance of not omitting the echocardiographic search for a defect of the roof of the interatrial septum in front of a volumetric overload of the right cavities.