{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:04:20Z","timestamp":1776755060991,"version":"3.51.2"},"reference-count":9,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,1,19]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>We report a case of a 28-year-old man lost to follow-up with chronic hypoxaemia and a history of an uncorrected tricuspid hypoplasia, perimembranous ventricular septal defect (VSD) and pulmonary stenosis. Given this initial diagnosis, chronic hypoxaemia was deemed to result from right-to-left shunt through the VSD driven by elevated right ventricle pressures. However, the further investigation identified an inferior sinus venosus atrial septal defect, unveiling the true mechanism behind the clinical scenario. The patient was submitted to surgical correction with clinical improvement. This case illustrates the defiant evaluation of this type of atrial septal defect through echocardiography and underlines the importance of a multimodal evaluation to reach an accurate diagnosis and optimal management.<\/jats:p>","DOI":"10.1136\/bcr-2021-248330","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T11:06:23Z","timestamp":1646219183000},"page":"e248330","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Long-standing hypoxaemia in complex adult congenital heart disease: anatomical and functional interplay in an uncommon presentation"],"prefix":"10.1136","volume":"15","author":[{"given":"Cl\u00e1udia Jesus","family":"Silva","sequence":"first","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Madeira","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Abecasis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Anjos","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Hospital Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"2025082711085855000_15.3.e248330.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.714402"},{"key":"2025082711085855000_15.3.e248330.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa554"},{"key":"2025082711085855000_15.3.e248330.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.190690"},{"key":"2025082711085855000_15.3.e248330.4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.euje.2005.04.006","article-title":"Inferior sinus venosus defect associated with incomplete cor triatriatum Dexter and patent foramen ovale","volume":"7","author":"Kessel-Schaefer","year":"2006","journal-title":"Eur J Echocardiogr"},{"key":"2025082711085855000_15.3.e248330.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.78.3.298"},{"key":"2025082711085855000_15.3.e248330.6","first-page":"1029","article-title":"Unsuccessful lung scan due to major right-to-left shunt through a sinus venosus septal defect","volume":"26","author":"Brendel","year":"1985","journal-title":"J Nucl Med"},{"key":"2025082711085855000_15.3.e248330.7","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1999.1944"},{"key":"2025082711085855000_15.3.e248330.8","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.2169\/internalmedicine.50.5290","article-title":"Atrial right-to-left shunt without pulmonary hypertension in a patient with biventricular non-compaction cardiomyopathy accompanied by ventricular and atrial septal defects","volume":"50","author":"Sakan","year":"2011","journal-title":"Intern Med"},{"key":"2025082711085855000_15.3.e248330.9","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4277"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:09:03Z","timestamp":1756318143000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,2]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/bcr-2021-248330"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248330","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}