Atrial Septal Aneurysms: The Heart's Hidden Bulge

Atrial septal aneurysms (ASAs) are usually asymptomatic and discovered incidentally during routine cardiac imaging. While their exact prevalence is unclear, ASAs can be associated with structural heart defects (such as patent foramen ovale or atrial septal defect) and carry risks of systemic embolization, arrhythmias, and potentially migraine headaches. The diversity of current diagnostic criteria highlights the need for a standardized approach in research and clinical practice. Imaging modalities such as echocardiography, cardiac magnetic resonance imaging, and computed tomography are used for diagnosis. Isolated ASAs may only require follow-up, while those with complications or associated defects may require invasive interventions. This review aims to provide a detailed overview of ASAs, emphasizing the need for standardized diagnostic criteria and a multidisciplinary approach to patient management.