Double-Chambered Right Ventricle in Adults: Characteristic Echocardiographic Features from an Incidental Case

Desita Asri Yulistina; Putri Dwi Anggreheni; Putri Isa Maharani Yaasiin; Rafif Ryandra Izdhihar; Nanda Nurkusumasari

doi:10.30701/ijc.1849

Desita Asri Yulistina Clinical Medical Student, Faculty of Medicine, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia
Putri Dwi Anggreheni Clinical Medical Student, Faculty of Medicine, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia
Putri Isa Maharani Yaasiin Clinical Medical Student, Faculty of Medicine, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia
Rafif Ryandra Izdhihar Clinical Medical Student, Faculty of Medicine, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia
Nanda Nurkusumasari Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Muhammadiyah Surakarta/RS PKU Muhammadiyah Solo, Surakarta, Indonesia

Keywords: Adult congenital heart disease, double-chambered right ventricle, echocardiography, ventricular septal defect

Abstract

Background: A Double Chambered Right Ventricle (DCRV) is an uncommon congenital heart defect in which an abnormal muscular bundle divides the Right Ventricle (RV) into two chambers with different pressure levels. Diagnosing DCRV in adults is challenging because it is often asymptomatic and may be misdiagnosed.

Case Illustration: We present a 37-year-old male with a history of an uncorrected Ventricular Septal Defect (VSD), who was incidentally found to have type 2 DCRV on echocardiography during evaluation for abdominal pain. No residual VSD was detected, possibly due to spontaneous closure. Electrocardiography (ECG) revealed first-degree Atrioventricular (AV) block. Chest radiography showed cardiomegaly with a Cardiothoracic Ratio (CTR) of 0.56. Transthoracic Echocardiography (TTE) demonstrated an anomalous muscular bundle that divided the RV into a high-pressure proximal chamber and a low-pressure distal chamber, accompanied by left atrial and ventricular enlargement.

Conclusion: DCRV in adults is often misdiagnosed as pulmonary stenosis, especially in patients with mild or no symptoms. TTE and Doppler imaging are key diagnostic modalities for accurate diagnosis; however, advanced imaging techniques such as Transesophageal Echocardiography (TEE) may be required in complex cases. Management includes symptom control, such as beta-blockers, and further evaluation to determine the need for surgical intervention.

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