Introduction: The association between secundum atrial septal defect and mitral valve disease has been recognized for many years.
Case presentation: A female patient was admitted to the hospital with sudden onset of congestive heart failure symptoms. Diagnostic methods revealed an enlarged right ventricle, secundum atrial septal defect, tricuspid regurgitation and pulmonary hyper- tension, mitral regurgitation with chordal rupture of the mitral valve. Treatment involved replacement of the mitral valve with a mecha- nical prosthesis and closure of the atrial septal defect with sutures.
Conclusion: In a patient with asymptomatic atrial septal defect, a sudden increase in left to right cardiac shunting due to acute mitral regurgitation precipitated right heart failure.
secundum atrial septal defect, mitral valve disease, right heart failure