title: Massive interventricular septal aneurysm and stroke in a healthy young patient: guilt by association?
abstract: Aneurysm of the membranous interventricular septum is an uncommon cardiac defect that is, on rare occasions, associated with embolic stroke. We describe here the case of an otherwise healthy, 41-year-old man who presented to the hospital with acute-onset confusion and left-sided body weakness attributed to a right middle cerebral artery ischemic stroke. He experienced a nearly complete resolution of deficits following systemic thrombolytic therapy. After an extensive workup, the presumed mechanism of stroke was a thromboembolus that originated in a massive aneurysm of the patient's membranous interventricular septum. Due to a perceived risk of surgical morbidity, the patient was managed conservatively with anticoagulation. He denied further events and reported nearly full function at follow-up.
authors.affiliation: Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota. Electronic address: sten0105@umn.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Stendahl
authors.affiliation: Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; Division of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota; Division of Cardiology, Department of Medicine, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: Amatul S
authors.initials: AS
authors.lastname: Hasan
authors.affiliation: Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; Division of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Mengistu A
authors.initials: MA
authors.lastname: Simegn
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D006322:Heart Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054088:Ventricular Septum / Q000000981:diagnostic imaging
chemical_list: D000925:Anticoagulants
keywords: Thromboembolism; echocardiography; membranous interventricular septal aneurysm; membranous interventricular septum; stroke