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Atrial Septal Aneurysm

ASA


Presentation

  • The present study represents both clinically manifested and silent atrial septal aneurysms. Moreover, female gender predominance is also reported.[ncbi.nlm.nih.gov]
  • The patient presented persistent postoperative atrioventricular block, which required a permanent pacemaker. Clinical evolution was satisfactory.[ncbi.nlm.nih.gov]
  • She has an atrial septal defect with atrial septal aneurysm, which remained undiagnosed until this clinical presentation.[ncbi.nlm.nih.gov]
  • The present report discusses a case of noncompaction of the ventricular myocardium in a 51-year-old woman with dilated cardiomyopathy of unknown etiology.[ncbi.nlm.nih.gov]
  • We present an adult patient with this unusual anomaly combined with a single coronary ostium emerging from the right sinus of Valsalva. The ASA was excised and the defect repaired successfully.[ncbi.nlm.nih.gov]
Leg Edema
  • The patient had jugular venous distension and 2 leg edema bilaterally. His vital signs were normal, and laboratory blood tests showed normal hemoglobin level and kidney function.[mdedge.com]
Pulse Deficit
  • Clinical examination reveals an irregular pulse, at 102 beats per minute (bpm), pulse deficit of 6 bpm, and a 130/80mmHg blood pressure. Peripheral pulses are normal. Cardiovascular system examination confirms irregular heart.[escardio.org]
Left Ventricular Dysfunction
  • Additional Sources of Embolism in 28 Patients With Cerebral Ischemia and Atrial Septal Aneurysm Embolism Source Patients No. 1 % Intracardiac thrombus 1 4 Prosthetic valve 2 2 7 Aortic atherosclerosis 3 2 7 Left ventricular dysfunction 4 2 7 Atrial fibrillation[circ.ahajournals.org]
Paresis
  • Here we present a 40 years male patient presents with right middle cerebral artery ischemic stroke with left sided hemi paresis, seizures and altered sensorium. All blood parameters and Doppler imaging showed normal study.[scopemed.org]
Flank Pain
  • A 53-year-old woman presented with flank pain and hematuria. She was suspected of having a renal stone but instead was found to have segmental renal infarction.[ncbi.nlm.nih.gov]

Workup

  • In addition to cerebral computed tomography (in 535 patients) or magnetic resonance imaging (in 428), all patients had a standardized workup to rule out definite causes of stroke.[nejm.org]
  • […] embolism resulting in a right to left shunting of blood [36] Treatment [ edit ] Patent Foramen Ovale [ edit ] Most patients with a PFO are asymptomatic and do not require any specific treatment. [37] However, those who develop a stroke require further workup[en.wikipedia.org]
Streptococcus Bovis
  • Streptococcus bovis endocarditis is a frequent cause of streptococcal endocarditis and is associated with colonic tumours. The tricuspid valve is very rarely affected and its involvement is a complication which can lead to a less favourable outcome.[ncbi.nlm.nih.gov]

Treatment

  • Most patients with this condition are given life-long anticoagulation, a treatment that may have serious complications. As an alternative treatment with possible lower risk, we removed the aneurysm surgically.[ncbi.nlm.nih.gov]
  • OBJECTIVES: This study sought to investigate the safety and efficacy of transcatheter treatment of atrial septal aneurysm (ASA) associated with patent foramen ovale (PFO).[ncbi.nlm.nih.gov]
  • The treatment by radiofrequency appears as an effective and well tolerated treatment of this unusual left atrial tachycardia.[ncbi.nlm.nih.gov]
  • On the contrary, in patients following the first event of transient ischemic attack, or a recurrent event during antiplatelet treatment, the percutaneous closure of PFO is recommended.[ncbi.nlm.nih.gov]
  • In view of the risk of systemic thromboembolism or the need for lifelong anticoagulation treatment, the aneurysm was excised and an atrial septal patch was fashioned to close the resultant defect.[ncbi.nlm.nih.gov]

Prognosis

  • Thomas' Hospital, London, United Kingdom. aphrodite.tzifa@kcl.ac.uk Abstract Atrial septal restriction is estimated to occur in up to 22% of patients with hypoplastic left heart syndrome and is associated with poor prognosis postnatally.[ncbi.nlm.nih.gov]
  • The prognosis also depends on the stage at which the patient presents. The earlier the patient presents with symptoms, the worse is the prognosis. Children usually present with high output cardiac failure.[jpma.org.pk]
  • Prognosis after stroke followed by surgical closure of patent foramen ovale: a prospective follow‐up study with brain MRI and simultaneous transesophageal and transcranial Doppler ultrasound.[ncbi.nlm.nih.gov]
  • […] exertion of the heart and prevent further growth of the aneurysm Antiarrhythmic treatment Prevention education for patients about the mural thrombus and thromboembolic complications Effective drug control symptoms for heart aneurysm vastly improve patient prognosis[hmcisrael.com]

Etiology

  • Postoperative stroke can have many etiologies including cerebral thrombosis, embolism, and hemorrhage. If there is a right-to-left intracardiac shunt, paradoxical embolism may also occur.[ncbi.nlm.nih.gov]
  • The main objective of the study was to assess the role of ASA morphology in the etiology of embolism. METHODS: Eighty-eight subjects were included after transthoracic echocardiography positive for ASA.[ncbi.nlm.nih.gov]
  • The present report discusses a case of noncompaction of the ventricular myocardium in a 51-year-old woman with dilated cardiomyopathy of unknown etiology.[ncbi.nlm.nih.gov]
  • BACKGROUND: The purpose of the present study was to assess the contribution of embolic etiologies, patent foramen ovale (PFO) and atrial septal aneurysm (ASA), to cerebral white matter lesions (WMLs) in ischemic stroke patients.[ncbi.nlm.nih.gov]
  • […] imaging Heart Aneurysm/therapy Heart Septal Defects, Atrial/complications* Heart Septal Defects, Atrial/diagnostic imaging Heart Septal Defects, Atrial/therapy Humans Incidence Ischemic Attack, Transient/diagnostic imaging Ischemic Attack, Transient/etiology[ncbi.nlm.nih.gov]

Epidemiology

  • The resources of the Rochester Epidemiology Project were used to enumerate the Olmsted County population 45 years old. 4 The SPARC sampling process was designed to randomly select 580 subjects, stratified by sex and 5 age subgroups (45 to 54 years, 55[circ.ahajournals.org]
  • Cardiac tamponade may occur if the rupture involves the pericardial space. [1] Epidemiology Frequency United States SVA was present in 0.09% of cadavers in a large autopsy series and ranged to 0.14-0.23% in a Western surgical series. [4] Two-dimensional[emedicine.medscape.com]
  • Epidemiology Frequency International Several echocardiography and postmortem studies indicate that the foramen remains competent in 30% of patients with otherwise normal cardiac anatomy. Hagen PT, Scholz DG, Edwards WD.[emedicine.medscape.com]
  • Percutaneous closure is the method of choice in most centres. [53] Studies evaluating percutaneous ASD closure among pediatric and adult population show that this is relatively safer procedure and has better outcomes with increasing hospital volume. [54] [55] Epidemiology[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • These findings suggest that impaired LA and LAA functions are a crucial pathophysiologic mechanism for ischaemic stroke in subjects with ASA alone.[ncbi.nlm.nih.gov]
  • The resultant similarities to the pathophysiology of AF might represent an additional contributing mechanism for arterial embolism in such patients.[ncbi.nlm.nih.gov]
  • Surgical repair of the defects led to resolution of symptoms. 9–11 The pathophysiologic mechanism described in these patients is that right ventricular myocardial infarction, pulmonary embolism, and pneumonectomy all elevate right ventricular pressure[ncbi.nlm.nih.gov]
  • Short of breath symptom and cause: A right to left ASA can be secondary and the pathophysiologic mechanism can be the result of the right ventricular myocardial infarction (heart attack), pulmonary embolism (clot), and pneumonectomy, etc will elevate[medhelp.org]

Prevention

  • There are inconclusive data on the efficacy of PFO closure to prevent stroke recurrence. However, if there is recurrent stroke or intolerance to medical therapy, percutaneous closure is carried out.[ncbi.nlm.nih.gov]
  • Ensuring safety of young athletes and employees who perform hard physical work within the scope of their professional duties, with a special focus on prevention of a sudden cardiac death at sports fields or during hard physical work is one of the most[ncbi.nlm.nih.gov]
  • Long-term prevention of recurrent events appears favorable when compared to patients with PFO alone.[ncbi.nlm.nih.gov]
  • Recurrent stroke prevention Various treatment modalities are available for secondary prevention in patients with cryptogenic stroke who on assessment have PFO.[ncbi.nlm.nih.gov]
  • For example, if your husband has already had a stroke, then anticoagulation with blood thinners may be indicated to prevent another stroke.[zocdoc.com]

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