Cor Triatriatum and Recurrent Thromboembolic Stroke

A woman with recurrent thromboembolic stroke was found to also have cor triatriatum. When the patient first presented with weakness, she was thought to have ischaemic stroke because she had conventional risk factors, but she was later confirmed to have cor triatriatum. The main method of treatment is surgery. However, if surgery is contraindicated, anticoagulation can be used as second-line treatment, but this can be difficult. This report describes the follow-up of a middle-aged female patient with cor triatriatum over 6 years during which she experienced multiple strokes despite different methods of anticoagulation. LEARNING POINTS: Cor triatriatum is a rare heart condition which may not be detected by routine transthoracic echocardiography and so requires transthoracic echocardiography and CT angiography. Surgical membrane resection is the main treatment option but thromboembolic stroke should be considered when surgery is not possible. Anticoagulation may not be as effective at preventing embolic stroke in this rare heart defect as it is in other conditions.