Detachment of defective septum primum. A potential source of embolism?

Cardiac sources of embolic stroke include various abnormalities of the atrial septum. An atypical detachment of the septum primum was detected in two patients by dynamic three-dimensional echocardiography (DTDE). Between the septum primum and septum secundum a cavity with interatrial communication was detected. Within the cavity a turbulent color Doppler signal and an entry of the contrast agent EchovistR were detected. One of the patients suffered from repeated cerebrovascular events. This unusual defect of the atrial septum may be a potential source of embolism. Transesophageal echocardiography is considered the most sensitive method for the examination of the atrial septum. However, clear anatomic details could only be shown by DTDE.