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Congenital Gerbode Defect in a Patient With an Acute Myocardial Infarction and Cardiogenic Shock Masquerading as an Acute Ventricular Septal Defect.

EFT VENTRICLE-TO-RIGHT ATRIUM (LV-RA) shuntsare rare congenital or acquired defects of the membranousseptum described by Gerbode in 1958; their natural history canlead to enlargement of the right atrium and right ventriclefailure. Often the defects go unnoticed at birth, and diagnosis ismade in adulthood. The authors report a case of a 75-year-oldwoman with an acute myocardial infarction and cardiogenicshock for whom preoperative echocardiograms were readincorrectly as an infarct-related ventricular septal defect(IRVSD). The recognition of the pre-existing congenital LV-RA Gerbode malformation (GM) was made at the time ofsurgery for coronary revascularization, mitral and tricuspidannuloplasty, patent foramen ovale (PFO) closure, and ven-tricular septal defect (VSD) repair. The authors will review theimportant echocardiographic differences between the rare, pre-existing, congenital GM and the more common IRVSD.