A 22-year-old
male presented with recurrent
stroke, central
cyanosis, and
dyspnea.
Transesophageal echocardiography and
cardiac catheterization revealed bidirectional shunt flow through
atrial septal defect (ASD) without
pulmonary arterial hypertension. The orifice of
inferior vena cava facing towards ASD opening led partially right to left shunt resulting in
cyanosis with normal pulmonary
arterial pressure.