Posted by: Joy | 2011/12/07

septum aneurysm

Hi Dr, about 10 yrs ago when I was 29 I had a test called a transesopageal echo and was told by the specialist physician that I had a bit of a thin section of the septum of my heart and he used the words slight aneurysm - I was also diagnosed with a pacing problem and have a pacemaker (bradycardia) - my question is, is the ''septum thingy'' something that I should be worried about, does it get better/worse/stay the same on it''s own?

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Our expert says:
Expert ImageCardiologist

Hello Joy. Aneurysms of the atrial septum (the wall between the left and right upper chambers of the heart) are uncommon and usually harmless.. However, when an atrial septal aneurysm is associated with a patent foramen ovale (a hole in the heart, between the two upper chambers), it can The way this works is as follows. If there is a hole between left and right atria, blood flow is normally from left to right because pressure in the left atrium is higher than in the right. Under certain conditions, however, such as coughing, pressure in the right atrium may exceed that in the left atrium and any blood clot present in the right atrium at the time may therefore enter the left atrium and from there find its way into the circulation and into the brain, causing stroke. In this way atrial septal aneurysm may occasionally lead to stroke.

However it is important to bear in mind that strokes in young people are rare, and only a small proportion of them are caused by paradoxical embolism related to an aneurysm of the atrial septum. Nevertheless, a stroke is the very last thing anybody wants or needs. My advice would be to see a cardiologist and arrange for a repeat echo, either transthoracic or transoesophageal, combined with a technique to try to show whether there is in fact a “hole” in the atrial septum, eg a “bubblegram”. If you do not have a defect (a patent foramen ovale) then you do not need to worry about stroke and the atrial septal aneurysm can be ignored. If on the other hand you do have a hole (patent foramen ovale) then you could consider having the hole closed. Using modern techniques this is fairly easy to do through the groin, without resorting to heart surgery.

Best wishes. JT

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