We describe a 42-year-old man with rheumatic mitral stenosis, sinus ve
nosus atrial septal defect, and anomalous drainage of the right upper
pulmonary vein to the superior vena cava. Transthoracic echocardiograp
hy (TTE) failed to identify the atrial septal defect and the partial a
nomalous pulmonary venous return. Transesophageal echocardiography (TE
E), using a multiplane probe, teas useful in delineating the abnormali
ties. To our knowledge, this is the first reported patient with rheuma
tic mitral stenosis and sinus venosus defect.