What does "Interatrial septum is aneurysmal"

[michelle23]

I had an Echo 2D M-Mode C/Full Doppler because of shortness of breath and chest pressure. The conclusions said "normal echocardiogram", but as I was reading the full report under the Left Atrium heading it says, "The left atrium is normal in size. The interatrial septum is aneurysmal." What does that finding mean??

[ayl291]

Yes, it can cause Dyspnea.

This is due to several hemodynamic factors...

1. Atrial and ventricular coupling
2. Frank starling and impeding the preload
3. Law of laplace
4. If it is hypermobile than you would be even more short of breath on every repsiratory cycle due to volume influx essentially moving the " wall"...

With all that said this is not dangerous and very fixable!

Feel free to let me know if you have any questions!

[Smiley2000]

Hi there,

I also have an ASA and unless it is of a significant size, they can not do anything about it and nothing to be concerned about.

A T.E.E. can be done to check for PFO/shunt.

All the best and please keep us informed.

[BooDoodles]

Hi, Just got diagnosed with ASA and set up with cardiologist for more details. Wouldn't take it lightly. Get info. You could also have a PFO which is a hole in septum. PFO is patent foremen ovale. Check it out on internet.
Linda

[kenkeith]

Michelle, I assumed the normal left to right pressures cause a  cardiac septum malformation defined as a localized thinning and bulging of the atrial septum into the right atrium.  I came to the conclusion based on the doctor's report expressing anxiety is/was the cause of your symptoms.  But the aneurysm can be an abnormal right to left intra-chamber pressure causing the septum to bulge into the left atrium.

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 right ventricular pressure, leading to a right-to-left shunt through the ASA and the associated interatrial defect.  Sometimes the thin wall becomes perforated (small holes) rather than rupture. The hemdynamics from right side pressure results in some right side blood getting into the left atrium. This blood has not been cycled through the lungs and can contain clots...so there is a danger of clots getting into the system and an anti-platelet med is recommended.

The doctor's report did not comment left to right shunting, or right to left shunting or both... what needs to be watched is whether or not in the future there is perforation or rupture that would involve hemodynamic shunting and if serious, repair.  

[michelle23]

I really appreciate your responses and I think I am going to call my doc on Monday. What exactly does  "it needs to be watched" mean? I have been suffering from morning shortness of breath and chest pressure, that usually subsides within a couple of hours. I have been tested for sleep apnea and it came up negative. My doctor thinks it's anxiety but I don't agree. Would those symptoms be associated with the "interatrial septum is aneurysmal" issue. Do you think I should consult a cardiologist?
Thanks again!
Hope you have a lovely weekend.

[kenkeith]

QUOTE: "So is this something that needs to be addressed? When the results came in July, the Dr. said everything was fine.
I appreciate your help!"

Michele, there are no symptoms associated with an aneuysm.  Needs to be watched and unless there is an increase in intra-arterial pressure it may never progress or rupture.  Because the left atrial pressure is greater than the right side, a rupture would shunt some of the left side atrial blood into the right side atrium.

If there is a rupture that in itself would not be life threatening and is easily repaired using cath and insert a device that covers the rupture in the septum. The device is made out of metal mesh and is springy and flexible.  There are people that go through life with a small hole in the septum without symptoms or repair, but if severe would cause shortness of breath and chest pain and require treatment.

[Me967]

Interatrial septal aneurysms show up on an echo in which without the echo you probably would not even know you had it.  New technology picks up so very much now.  
I was told not to worry about it; but, to take low dose asprin the rest of my life as a preventative for a stroke.   I didn't think they could rupture though.  Hopefully someone else will chime in.  That is just what I was told.  Take care.  ;~)              Amy

[michelle23]

So is this something that needs to be addressed? When the results came in July, the Dr. said everything was fine.
I appreciate your help!

[kenkeith]

The left atrium (upper left chamber) is normal size.  The wall (septum) that separates the left and right atria has an abnormal bulge (aneurysm).  It usually means the wall is thinner than normal. Intra atrium pressure (normal) cause the bulge. That would not be the cause of your symptoms.

If the aneurysm ruptures, some blood will flow from the left atrium to the right atrium and recycled through the lungs. If serious (large rupture) less blood would go into circulation than normal and that could cause SOB and chest pain.