Background: Ostium primum (OP) atrial septal defect (ASD) is most commonly associated with the mitral valve cleft. Shunting is predominantly left-to-right, resulting in volume overload of the right heart and pulmonary circulation. SARS-CoV-2 viral infection causes pulmonary fibrosis.

We present 42 years female known from childhood with an uninvestigated cardiac murmur, admitted with dyspnea at minimal exertion. Two months before admission, she had a ospitalization in an Infectious Disease Department for a SARS-CoV-2 infection with moderate

respiratory symptoms. Despite a correct treatment, dyspnea accentuated progressively after COVID -19 discharge.

A NON-SEVERE SARS-COV-2 VIRAL INFECTION DOES NOT REPRESENT A BENIGN DISEASE Despina-Manuela Toader, Alina-Crăciun Mirescu, Anca Popa, Georgiana Magareață, Ionela Munteanu,

Craiova Cardiology Center, Craiova,

Methods: clinical examination, laboratory blood tests, ECG, Chest X-Ray, thoracic TC scan, 2D/4D transthoracic (TTE), and transesophageal (TEE) echocardiography.

Results: clinical examination: a grade 2 systolic murmur at the second left intercostal space, and a grade 3 systolic murmur in the 4th left intercostal space.

ECG: R' wave in V1 lead. Laboratory analysis in a normal range .

Chest X-Ray: pulmonary fibrosis,

cardiomegaly, dilated central

pulmonary arteries.

Qp/Qs: 2.1

Thoracic TC scan confirmed pulmonary fibrosis, without thrombosis. The patient was scheduled for surgical intervention.

ASD AND IVS ANEURYSMPS LAX VIEW: LVOT DEFORMATION

COLOR DOPPLER: ASD AND A SMALL

COMMUNICATION AT THE ANEURYSMAL

LEVEL

ANTERIOR MITRAL VALVE CLEFT SYSTEMIC FLOW CALCULATION: 8.4 L/M2

PULMONARY FLOW CALCULATION : 17.85L/M2 TAPSE TISSUE DOPPLER AT THE TRICUSPID VALVE LEVEL

LVEF – SIMPSON METHOD

LV GLS CALCULATION BY 2D STE 4D: PLANIMETRIC MR VC MEASUREMENT TEE: MR TEE: PW DOPPLER AT THE LUPV LEVEL PASP ESTIMATION

Conclusion: We presented an OP-type ASD with severe mitral and tricuspid regurgitation. Despite the large defect dimension and severe valvular regurgitations, the disease was well-

tolerated over time. The patient became symptomatic after a moderate form of SARS-Cov-2 viral infection. Although we did not know the value of pressure in the pulmonary artery before

the infection, we may suggest that post-COVID-19 fibrosis further contributed to symptoms precipitation..

TEE: ASD OP TYPE