title: Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events.
abstract: Patient records in 36 consecutively identified patients with typical echocardiographic findings of atrial septal aneurysm were reviewed. Ten of the 36 (28%) had cerebrovascular events. Of these 10, 5 had completed strokes of definite embolic origin on the basis of clinical, angiographic, and computed tomographic findings; 2 had transient ischemic attacks of probable embolic origin. One of the 36 patients had a definite peripheral vascular embolus. Thus, 6 of 36 consecutively identified patients with atrial septal aneurysm (17%) had definite embolic events and 8 of 36 (22%) had definite or possible embolic events. The cause of the association between atrial septal aneurysm and emboli is unknown. While aneurysm-associated thrombus has been suggested, the high proportion (90%) of patients with interatrial shunting demonstrated by contrast echocardiography in this study suggests paradoxical embolization as a potential cause. Whatever its mechanism, the high prevalence of embolic events in this series strongly supports the premise that atrial septal aneurysm is a cardiac abnormality with embolic potential.
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000209:etiology*; D004452:Echocardiography; D004617:Embolism / Q000209:etiology*; D005260:Female; D006322:Heart Aneurysm / Q000150:complications* / Q000175:diagnosis; D006346:Heart Septum; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies