A rare anomaly

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A 26 year-old male presented with a history of neck pulsations over a period of 4 months, on examination he had elevated JVP with cannon.A waves, hyperdynamic LV apical impulse, diastolic murmur at apex, ECG showed sinus rhythm, markedly prolonged PR interval (360 msec), 2D ECHO showed dilated ostioproximal RCA and a echofree space communicating with posterobasal LV with diastolic predominant blood flow.

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Authors

Sivalingam Jegan¹, Alagarsamy Mathavan¹

1. Hannah Joseph Hospital, Tamil Nadu, INDIA