HEART DISEASE
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atrial septal aneurysm
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by plz help, Dec 31, 2005
I HAVE BEEN RECENTLY DIAGNOSED WITH HAVING A LARGE ATRIAL SEPTAL ANEURYSM WITHOUT ASSOCIATED ASD,WITHOUT APPERENT THROMBUS.I HAVE HAD SEVERAL ECHO'S DONE AND ALSO A TEE,THE CONCLUSIONS OF THE TEE WERE AS FOLLOWS....
1.LARGE INTRAATRIAL SEPTAL ANEURYSM WITHOUT ASSOCIATED ATRIAL SEPTAL DEFECT,WITHOUT APPERENT THROMBUS.
2. HYPERTROPHIC CARDIOMYOPATHY WITHOUT ASSOCIATED OBSTRUCTION.
THE MAIN QUESTIONS I HAVE INVOLVE THE SERIOUSNESS AND TREATMENT OPTIONS AVAILABLE FOR THIS ANEURYSM.I AM A 25 YEAR OLD WHITE MALE WITH GENERALLY GOOD HEALTH.CURRENTLY MY BP IS UNCONTROLLED RUNNING ABOUT 150/100 WITH A APICAL PULSE OF ABOUT 95,I HAVE CHEST PAINS WHEN I BEND OVER AND HAVE BAD PALPATATIONS FREQUENTLY,ALSO I HAVE EXTRA BEATS AND DONT KNOW WHAT CAUSES THEM A HOLTER MONITOR SHOWED 1400 EXTRA BEATS IN A 21 HOUR PERIOD.I AM CURRENTLY ON A 81MG ASPIRIN,100MG OF TOPOROL,32MG OF ATACAND,AND A ALLEVE FOR THE CHEST PAINS.MY CARDIOLOGIST SAYS LETS KEEP AN EYE ON IT FOR NOW AND NOT TO DO ANYTHING ELSE,WHAT IS YOUR TAKE ON IT? SHOULD I HAVE THIS SURGICALLY TAKEN CARE OF,OR CAN IT BE LEFT ALONE?CAN IT RUPTURE?WHAT SYMPTOMS ARE ASSOCIATED WITH THIS ANEURYSM?WHAT SURGICAL PROCEDURES ARE THERE FOR IT.SHOULD I WATCH WHAT I DO?MY TAKE ON IT IS I WANT IT REPAIRED NOW NOT WHEN SOMETHING HAPPENS TO ME LIKE A STROKE.HEART PROBLEMS ARE STRONG IN MY FAMILY...BROTHER HAD ASD REPAIRED AT 7 YEARS OLD AND JUST RECENTLY HAD A STROKE WITHOUT CAUSE,FATHER HYPERTENSION,AND NOW I HAVE HYPERTENSION AND THIS ANEURYSM,ANY CAUSE FOR CONCERN?? IF YOU WERE TREATING ME WHAT WOULD YOU DO? THANKS FOR THE HELP!
Answer:
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by CCF-M.D.-MJM, Dec 31, 2005

Hello,

Take a deep breath.  You sound pretty stressed about this.

1. THE MAIN QUESTIONS I HAVE INVOLVE THE SERIOUSNESS AND TREATMENT OPTIONS AVAILABLE FOR THIS ANEURYSM.

If you have an atrial septal aneurysm with no shunt or flow across the aneurysm, there isn't much that needs done.  It is true that aneurysms have a higher incidence of patent foremen ovales, but this should have been appearant by the TEE.  I don't think you need to do anything about this right now.

The bigger concern is getting your blood pressure under control.  It sounds like you have familial essential hypertension and we don't know what causes that.  You should be worked up for secdondary causes like renal artery stenosis, coarctation and a host of others.  It is more likely that you have familial hypertension from what you mentioned above.

the next question is -- is the hypertrophy from the hypertension or something else.  your cardiologist needs to look into that question.  you didn't mention a family history of hypertrophic cardiomyopathy, but this should be evaluated.  Hypertrophic cardiomyopathy can cause chest pains.

I may have brought up more questions than I answered for you, but these are things your doctor should look into if they already have not.

I hope this helps.  thanks for posting.

2. HOULD I WATCH WHAT I DO?
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Member Comments (5)
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by ed6, Jan 06, 2006
I, too, have an atrial septal aneurysm (ASA) and my cardiologist told me something similar, namely, that in the absence of shunting there was little to worry about.  However, there are plenty of studies demonstrating that even for people with ASAs and no PFO or ASD (holes allowing for shunts), the stroke risk was greater.  My cardiologist's response to this was that those patients must have had holes that were never detected.  That theory still does not sit too well with me.  Nor does the emerging literature (not much, but a few articles) suggesting that blood clots (thrombi) can form in the aneursym itself because the blood tends to pool there.  I am not writing this to alarm you, but rather to let you know that I am in the same boat: having an ASA and not sure what the best course of action is.  I had a bubble TSE, which is less sensitive than a TEE, and it showed no shunt; I am trying to talk my doc into having a TEE.  I also will be exploring whether an aspiring (baby or adult) is a minimal prophylatic measure.  He is retesting for shunt in March.
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by plz help, Jan 08, 2006
ed6,
thanks for the input!i was told the tee was the best way to check for shunting and that they would be able to see the heart and what is going on with it much clearer.i am taking a baby aspirin 81mg once a day to help prevent clotting.i think we are both getting pretty much the same info...my dr. wants to do another echo in a few months too.thanks again for the input!!
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by leuvenaar, Feb 12, 2006
I'm also having an intra-atrial aneurysm. I'm 28 years old, male and normal weight ans lifestyle. 1,5 years ago i had a sort of cardiac arrest, but they couldn't prove troponin presence or arrythmias. They explained the arrest could be caused by stress because i was having exams and a hard year.
Doctors did a normal chest echo with doppler and found out there is a small/irrelevant shunt (L -> R). I never had a TEE or bubble echo.
In my opinion this aneurysm is big. I'm not taking pills like ASA for it.

My questions:
- What is the coincidence/occurence rate of this defect?
- This can be easily repaired with a sort of umbrella though an iliacal catheter, but should i let them do this (their advise was to do nothing at the moment)?
- Is it essential to take ASA with such diagnosis?
- Is feeling dizzy a side effect of this defect?

Hope someone can help me. Thanks!
best regards,
Leuvenaar
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by Kanchana, Feb 22, 2006
I have been diagonised and given a report that I have septal aneurysm.Iam 28 years old and got two children.Kindly let me know the consequences of the same and will I get a stroke.Iam really panic about my report and I had been informed by doctor that I have depression.Please let me know.
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