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Right- and left-sided interatrial septal aneurysm mimicking atrial tumor and stroke
H R Malaterre1, K Kallee, J C Deharo
1Centre Hospitalier Universitaire de Marseille, Hôpital de la Conception, France.
Insights
Two patients with cerebral embolization had interatrial septal aneurysms. These aneurysms mimicked tumors but were incidental findings, not the cause of stroke.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Cerebral embolization is a significant cause of stroke.
- Interatrial septal aneurysms are uncommon cardiac findings.
- Distinguishing true cardiac masses from incidental findings is crucial for stroke etiology.
Observation:
- Two patients presenting with stroke underwent transesophageal echocardiography.
- Case 1 revealed a right-sided interatrial septal aneurysm and internal carotid artery stenosis.
- Case 2 showed a left-sided interatrial septal aneurysm and aortic arch atheroma.
Findings:
- Interatrial septal aneurysms in both patients mimicked atrial cystic tumors or abscesses.
- Neither interatrial septal aneurysm was identified as the cause of cerebral embolization.
- The aneurysms were considered incidental findings in the context of stroke.
Implications:
- This case series highlights the importance of comprehensive stroke workup beyond apparent cardiac abnormalities.
- It emphasizes the differential diagnosis of atrial masses, including distinguishing aneurysms from tumors or abscesses.
- Understanding incidental findings like interatrial septal aneurysms is key to accurate stroke cause determination.
Abstract:
We report the cases of two patients with cerebral embolization and interatrial septal aneurysm. Transesophageal echocardiography required for stroke showed right-sided interatrial septal aneurysm in the first patient and left-sided interatrial septal aneurysm in the second. In the two patients, interatrial septal aneurysm was mimicking atrial cystic tumor or abscess. Significant internal carotid artery stenosis was found in the first patient and aortic arch atheroma with mobile components but no patent foramen ovale in the second patient. In the two patients, interatrial septal aneurysm appears to be only an incidental finding and not the true cause of stroke. Furthermore, we discuss the differential diagnoses of atrial masses.