This 25-years old man presented with an episode of right ventricular tachycardia. ARVD was the suspected diagnosis and the patient was sent for a cardiac MRI. The MRI showed a defect in the atrial septum (Fig. 1 and 4C cine). Since an echocardiogram had already been done and the ASD had not been reported, further studies were performed. A phase-contrast study with the plane of imaging positioned over the septum clearly showed flow across the septum (Fig. 2, PC cine). A contrast study was then performed as well, which clearly showed the contrast extending from the LA to the RA (perfusion cine).
The ASD was eventually reconfirmed on a subsequent echocardiogram. Note the dilatation of the RA and RV as well.
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