E-page Original Images: Double-chambered right ventricle associated with ventricular septal defect and subaortic stenosis in an adult

Double-chambered right ventricle (DCRV) is a relatively uncommon congenital cardiac defect. In a 47-year-old man admitted to our unit for chest pain, a Doppler transthoracic echocardiogram (TTE) was performed, showing: middle right ventricle (RV) hypertrophy, dividing the cavity into two chambers, with significant intraventricular gradient (85 mmHg) (Fig. 1, 2); dilatation of RV outlet part and of pulmonary artery trunk with mild pulmonary regurgitation; perimembranous ventricular septal defect (VSD) (7 mm) with moderate left to right shunt and interventricular gradient of 88 mmHg; subaortic spur with mild left ventricle output tract obstruction (systolic anterior movement of the mitral valve, midsystolic notch on aortic valve, gradient of 14 mmHg); fibrocalcification of aortic cusp and mild-moderate regurgitation; mild LV hypertrophy with normal systolic and diastolic function; mild dilatation of right and left atrium; mild tricuspid regurgitation and normal pulmonary artery pressure.