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We describe a patient with oedema of the legs and ascites due to right atrial (RA) inflow obstruction, caused by atrial septal aneurysm (ASA) and an elongated Eustachian valve (EV). Both structural abnormalities created a narrow inflow channel to the free RA cavity. RA inflow obstruction is usually related to constrictive pericardial disease and pericardial tamponade. Other cardiac causes of RA inflow obstruction are rare and include lipomatous hypertrophy of interatrial septum, tumour or thrombus in the right atrium (RA). Reports, describing inflow obstruction in the RA as a consequence of an elongated EV or an ASA, are extremely rare.

Right atrial inflow obstruction of the inferior vena cava due to atrial septal aneurysm and an elongated Eustachian valve