Comparative roles of the atrial septal aneurysm versus patent foramen ovale in systemic embolization with inferences from neonatal studies.
Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) have a significant statistical relation to ischemic strokes in adults. We reviewed their prevalence in 106 echocardiograms of neonates. Although all normal neonates have PFO, only 4% had ASA. From fetal and neonatal echocardiograms, we conclude that ASAs are more likely to be caused by inadequate size of the PFO, but the ASA can act as a funnel, enhancing the chances of paradoxic embolization in the presence of a PFO. There is no convincing evidence that an ASA alone causes strokes in adults; the confounder is probably atrial fibrillation.
Guntheroth
Warren G
WG
Pediatric Cardiology, University of Washington, Seattle 98195, USA. wgg@u.washington.edu
Schwaegler
Rebecca
R
Trent
Erin
E
D000328:Adult; D015150:Echocardiography, Doppler; D019320:Embolism, Paradoxical / Q000209:etiology*; D006322:Heart Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D006325:Heart Atria; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006346:Heart Septum; D006801:Humans; D007231:Infant, Newborn; D020766:Intracranial Embolism / Q000209:etiology; D012075:Remission, Spontaneous; D012307:Risk Factors