Surgical resection of cor triatriatum in a 74-year-old man. Review of echocardiographic findings with emphasis on Doppler and transesophageal echocardiography. A 74-year-old man was admitted to the hospital with congestive heart failure secondary to cor triatriatum. He also had sick sinus syndrome with complete heart block and syncope that had been treated with a permanent pacemaker 20 years earlier. The patient underwent successful surgical resection of the atrial membrane with closure of an atrial septal defect. M-mode, two-dimensional, Doppler, and transesophageal echocardiographic findings are reviewed. A unique "spike and dome" pattern on continuous-wave Doppler echocardiography is described that may suggest diagnosis of cor triatriatum. 