A 34-year-old male was evaluated for palpitation. Past medical history is significant for small PM-VSD years earlier with no intervention required. Physical examination was notable for an ejection systolic murmur (grade II/VI) over the left sternal border. ECG was unremarkable. TTE showed a small (4 mm) PM-VSD with left to right shunt and RV muscular septation causing no significant obstruction. TEE was confirmatory (, ). CMR showed prominent RVOT muscle bundles causing no significant flow turbulence (, ). No action was taken due to the benign nature of DCRV in this patient.
An asymptomatic 17-year-old male, with a history of surgical closure of PM-VSD at age 12, presents for routine follow-up. Physical examination was notable for an ejection systolic murmur (grade II/VI) at the left sternal border. ECG was normal. TTE revealed a RV muscular septation without significant obstruction (peak gradient of < 20 mm Hg). No residual VSD shunt was appreciated. CMR showed prominent RVOT muscle bundles causing no flow turbulence ( and , ). No action was taken due to the benign nature of DCRV in this patient.