Infravalvular type of Gerbode defect: a rare cardiac anomaly

A Gerbode defect is a rare type of ventricular septal defect (VSD), classically described as a direct communication between left ventricle (LV) and right atrium (RA).1 However, it may be supravalvular (direct shunt), infravalvular (indirect shunt) or mixed. The infravalvular type is a VSD with a left-to-right shunt at the ventricular level, associated with tricuspid regurgitation (TR), which directs the high-velocity shunt into RA.2 ,3 A 43-year-old woman presented with symptoms of dyspnoea and palpitations. Clinical examination revealed a pansystolic murmur and grade 2 parasternal heave. ECG depicted biventricular hypertrophy along with biatrial enlargement. Echocardiogram showed a 9 mm perimembranous VSD with left-to-right shunt (figure 1). Careful observation revealed two …