Aneurysm of the atrial septum as diagnosed by echocardiography: Analysis of 11 patients

Abstract

Atrial septal aneurysm (ASA) is considered uncommon and, when discovered, has usually been found in association with other cardiac lesions.1-4 This association has led some observers to conclude that their occurrence is the result of an increased pressure gradient between the atria producing a bulging septal shift toward the low pressure side.1*2 In contrast, Silver and Dorsey5 detected clinically silent aneurysm of the septum primum in 16 of 1,578 serially autopsied adults. Only 1 of their 5 hemodynamically studied patients had elevated left ventricular end-diastolic pressure. Atrial septal aneurysm has been found by 2dimensional echocardiography (2-D echo) in association with various congenital and acquired valvular diseases.334 A patient who had a myocardial infarction and ASA with phasic inspiratory right-to-left motion of the aneurysm was reported.6 Isolated case reports of ASA associated with a midsystolic click,7 and with no associated lesions,” have also been recently reported. The subject of our report is 11 cases of ASA shown by 2-D echo to exist in the absence of other identifiable structural cardiac abnormalities.