•Unroofed CS is a rare cause of atrial-level shunting and right heart dilatation.•Unroofed CS is commonly diagnosed in adulthood.•TTE is the primary modality to recognize and diagnose unroofed CS.•CCT and/or magnetic resonance imaging should be done as complementary studies before CS repair.
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Venkatesh et al. (2024) studied this question.
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