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Diagnosed with an Atrial Septal Aneurysm

How serious is an Atrial Septal Aneurysm?  I was born with an ASD, which now is an ASA.  I was told I would have to have a pace maker put in later.  I am a 33 year old female.  I was also told that I am at high risk for stroke.  My thoughts are, why be a ticking bomb by never knowing when I will have a stroke, or when the aneurysm will rupture and have the surgery to correct the issue now.  They say do not stress, well, I say welcome to life for one and for two, like I can live stress free from knowing I could die or have a stroke anytime.  Any information will help.  I've tried research, but there is not much on this.  Thank you in advance for all your help.
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MEDICAL PROFESSIONAL
Atrial septal aneurysms are commonly seen in the setting of an ASD, and having both does increase the risk of stroke (somewhere on the order of 7-15% lifetime risk). This does not mean that everyone with these anomalies will have a stroke, and it doesn't say anything about needing a pacemaker (your doctor may have been referring to a different indication for a pacemaker, because ASDs and ASAs aren't usually a big reason for pacemaker implantation). The treatment options for these anomalies include antiplatelet medication to decrease the risk of clot formation (aspirin, warfarin) versus surgical or percutaneous correction. There is no clear evidence that closure is better than medical therapy because it is not clear that strokes that occur in this population are actually related to the defect. Generally, they are not closed in asymptomatic patients, and some studies have even shown that surgical closure may actually increase the risk of psot-operative stroke.

Bottom line, if you are asymptomatic, there is probably no need to fix the defect, but you should take aspirin.
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Avatar universal
Thank you.  I'm not real familiar with correct terminology, but my arythmia is not good because of the aneurysm, which was determined by EKG tests.  That is why I was told I would have to have a pacemaker. Does that make sense?  Thanks for your feedback!!
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