Stroke, Vol 18, 856-862, Copyright © 1987 by American Heart Association
RN Belkin, BJ Hurwitz and J Kisslo
Patient records in 36 consecutively identified patients with typical
echocardiographic findings of atrial septal aneurysm were reviewed. Ten of
the 36 (28%) had cerebrovascular events. Of these 10, 5 had completed
strokes of definite embolic origin on the basis of clinical, angiographic,
and computed tomographic findings; 2 had transient ischemic attacks of
probable embolic origin. One of the 36 patients had a definite peripheral
vascular embolus. Thus, 6 of 36 consecutively identified patients with
atrial septal aneurysm (17%) had definite embolic events and 8 of 36 (22%)
had definite or possible embolic events. The cause of the association
between atrial septal aneurysm and emboli is unknown. While
aneurysm-associated thrombus has been suggested, the high proportion (90%)
of patients with interatrial shunting demonstrated by contrast
echocardiography in this study suggests paradoxical embolization as a
potential cause. Whatever its mechanism, the high prevalence of embolic
events in this series strongly supports the premise that atrial septal
aneurysm is a cardiac abnormality with embolic potential.
ARTICLES
Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events
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