ATRIUM COMMUNIS- REPORT OF A RARE CONGENITAL HEART DEFECT

Background Atrium communis, also known as common atrium with separate atrioventricular (AV) junctions is a rare congenital heart anomaly characterized by complete or near complete absence of the atrial septum without malformations of the AV valves or interventricular communications. It is often denoted as a single atrium. Case

Summary A 24-year-old woman presenting with childhood history of exercise intolerance with associated palpitations and recurrent respiratory tract infections. Physical examination revealed central cyanosis and digital clubbing. On cardiovascular examination, she had a pulse rate of 88 beats per minute, with occasional missed beats, blood pressure 100/50mmHg, laterally displaced apex with a left parasternal heave, a thrill at the left second intercostal space, an accentuated pulmonic component of the second heart sound and a grade 4 ejection systolic murmur maximal at the pulmonic window. Chest X-ray showed cardiomegaly, dilated pulmonary trunk and upper lobe diversion. Electrocardiography showed right ventricular hypertrophy, right bundle branch block, premature ventricular contractions and Crochetage sign. Echocardiography revealed a single atrium with no AV malformations or ventricular communications and features suggestive of pulmonary hypertension. She is currently being evaluated for possible intervention.

Conclusion The diagnosis of congenital heart defects is often delayed in resource poor settings due to inadequate newborn screening, resulting in delayed interventions and complications.