Atrial septal defect (ASD) is a common variety of acyanotic congenital heart defects and accounts for a significant portion of the operative volume in a cardiac surgical setup. Transthoracic echocardiography (TTE) has class I recommendation for initial and follow-up assessment of all congenital heart diseases. It has an indispensable role for diagnosis, assessment of hemodynamics as well as ventricular function, and ruling out other associated cardiac anomalies. Transesophageal echocardiography (TEE) is particularly useful for evaluation for transcatheter closure of ASD as well as for guidance during transcatheter or surgical closure of ASD. Three-dimensional echocardiography is now increasingly used for better assessment of ASD location, shape and dimensions, surrounding structures, rims as well as for real-time procedural guidance of percutaneous ASD closure. We provide a discussion on perioperative and peri-interventional transthoracic as well as transesophageal echocardiographic assessment of ASD, directed towards trainee cardiac anesthesia fellows/residents providing perioperative and peri-interventional anesthetic care as well as echocardiographic guidance in the operating room and cardiac catheterization laboratory.

Ruptured sinus of Valsalva (RSOV) is a rare but potentially fatal condition and is usually associated with congenital conditions like ventricular septal defect (VSD), aortic insufficiency, and bicuspid aortic valve.¹ Ruptured sinus of Valsalva is rare in pregnancy and if present, causes additional strain on the already stretched hemodynamics of a pregnant female.² Very few cases of an RSOV in pregnancy have been reported.^2,3 We describe a case of RSOV during pregnancy.

Carcinoid syndrome is the conglomeration of symptoms mediated by humoral factors produced by a neuroendocrine tumor. It is characterized by gastrointestinal hypermotility, bronchospasm, hypotension, and vasomotor symptoms. It is associated with carcinoid heart disease (CHD) in >50% of patients. We are reporting a case of a 69-year-old female who presented with congestive heart failure, platypnea-orthodeoxia syndrome with refractory diarrhea. After medical stabilization and diagnosing the female as a case of CHD with a primary tumor located at the ovary; she was planned for exploratory laparotomy, bilateral salpingo-oophorectomy, and retroperitoneal pelvic lymph node removal, followed by tricuspid valve (TV) intervention.

Chronic constrictive pericarditis (CCP) is inherently associated with diastolic dysfunction. However, the relationship between: (1) Lateral to medial mitral annular velocity and (2) The ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) to left atrial (LA) pressure is significantly altered in CCP. The present article highlights the same.