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- W37384858 abstract "A 25-year-old woman with 10 years of worsening dyspnea had a mid-diastolic murmur in the left inframammary region. Two-dimensional echocardiography showed thickening of the mitral valve leaflets with a doming anterior mitral leaflet and restricted posterior mitral leaflet movement, which suggested rheumatic involvement of the mitral valve. An echo-free structure in the posterior atrioventricular groove suggested an enlarged coronary sinus, which was confirmed in parasternal long-axis view (Fig. 1) and modified apical 4-chamber view with posterior tilt (Fig. 2). The mitral valve area was 0.6 cm2 by planimetry. The tricuspid valve was thickened and doming, and color-flow Doppler echocardiography showed moderate tricuspid regurgitation with a gradient of 26 mmHg (Fig. 3). There was no significant tricuspid stenosis. A contrast echocardiogram showed that air bubbles entered the right atrium through the coronary sinus when contrast medium was injected through the left antecubital vein, which suggested persistent left superior vena cava (Fig. 4). The maximum coronary sinus diameter was 4.5 cm. Such extreme dilation is quite uncommon.Fig. 1 Two-dimensional echocardiography (parasternal long-axis view) shows a thickened mitral valve (MV) and an extremely dilated coronary sinus (CS).Fig. 2 Two-dimensional echocardiography (modified apical 4-chamber view) shows a dilated coronary sinus (CS).Fig. 3 Color-flow Doppler echocardiography (modified apical 4-chamber view) shows tricuspid regurgitation (TR).Fig. 4 Contrast echocardiography (modified apical 4-chamber view) shows air bubbles entering the right atrium (arrow) from the coronary sinus (CS)." @default.
- W37384858 created "2016-06-24" @default.
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- W37384858 date "2011-01-01" @default.
- W37384858 modified "2023-09-25" @default.
- W37384858 title "Giant coronary sinus." @default.
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