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atrial septal aneurysm

Etiology: - congenital heart disease - occurs frequently in association with an patent foramen ovale Epidemiology: - found in 28-40% of ischemic stroke patients < 55 years of age Complications: - increased risk of embolic stroke* - risk of stroke is especially associated with aneurysm excursions of > 10 mm * reference 2 reports risk of recurrent stroke associated with both atrial septal aneurysm & patent foramen ovale, but not with either alone. * proposed mechanisms include: 1) paradoxical embolism from the venous circulation 2) thrombosis within the aneurysm 3) atrial arrhythmias Management: - when an atrial septal defect is identified incidentally, no further evaluation or intervention is necessary [1] - antiplatelet therapy is recommended for atrial septal aneurysm associated with cryptogenic stroke [1]

Related

patent foramen ovale (PFO)

General

vascular aneurysm

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 17 American College of Physicians, Philadelphia 1998, 2015
  2. Journal Watch 22(2):11, 2002 Mas JL1, Arquizan C, Lamy C et al Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med. 2001 Dec 13;345(24):1740-6. PMID: 11742048
  3. Burger AJ, Sherman HB, Charlamb MJ. Low incidence of embolic strokes with atrial septal aneurysms: A prospective, long-term study. Am Heart J. 2000 Jan;139(1 Pt 1):149-52. PMID: 10618576