BMJ Case Reports 2017; doi:10.1136/bcr-2016-218395

Cor triatriatum sinistrum: presentation of syncope and atrial tachycardia

  1. Samer Nashef3
  1. 1James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
  2. 2Department of Cardiology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
  3. 3Papworth Hospital NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Malcolm Avari, malcolmavari{at}
  • Accepted 11 January 2017
  • Published 14 February 2017


We present a rather unusual cause for syncope associated with atrial tachycardia. A man aged 39 years presented with an episode of syncope and narrow complex tachycardia. Further investigations, including transoesophageal echocardiography, identified cor triatriatum sinistrum (CTS), a rare congenital abnormality characterised by the atrium being divided by a fibrous membrane. Although it is rare, there has been an increase in diagnosis due to developments in diagnostic imaging techniques. Symptoms are related to the size of fenestrations within the fibrous membrane. Presenting symptoms can mimic those seen in mitral stenosis. It is a condition that can occur in isolation, but it can also be associated with other cardiac abnormalities such as an atrial septal defect (ASD) (as in this case). Surgery is the definitive treatment (this man had surgical repair of CTS and closure of ASD) and should be considered at any age if there are any associated symptoms or complications.


  • Contributors MA performed literature search, author and guarantor. SuN involved in identifying and managing the case, provided idea for article and clinic letters, author and guarantor. SaN contributed to management of the case and provided operation notes. ZK provided reports of investigations performed.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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