Interatrial septal aneurysm

Case contributed by Dr Imran Ahmad Khan

Presentation

Patient with dyslipidemia with chest pain on exertion from few weeks. Treadmill exercise testing - ECG (TMT) was positive for inducible ischemia. CT coronary angiogram was done to evaluate for coronary artery disease.

Patient Data

Age: 45 years
Gender: Male
ct

An interatrial septal aneurysm is noted with a saccular formation of the interatrial septum bulging into the left atrium. The aneurysm is protruding ~16 mm beyond the plane of the atrial septum. The diameter at the base of the aneurysm is ~ 27mm. There is no atrial septal defect or any obvious left to right shunt. 

Case Discussion

Aneurysm of interatrial septum is a rare but a well-recognized entity. Often found incidentally at 2D-Echo or CT coronary angiograms. The clinical significance is uncertain when it is an isolated abnormality. It may some times be associated with a patent foramen ovale or an atrial septal defect. There is a significantly increased risk of cryptogenic stroke when it is associated with a patent foramen ovale.

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