The dangerous fifth chamber: congenital left atrial appendage aneurysm

Aneurysms of the left atrial appendage are extremely rare. Enlargement of the left atrial appendage can be congenital or acquired. Dysplasia of the left atrial muscles leads to congenital left atrial appendage aneurysm and usually presents as atrial tachyarrhythmia or embolic events in the second or third decade of life. We report a case of an asymptomatic 12-year-old child with a congenital left atrial appendage aneurysm. Transthoracic and transoesophageal echocardiography demonstrated a large left atrial appendage aneurysm without thrombus or spontaneous echo-contrast. The patient was successfully treated with surgical resection of the aneurysm.     

Left atrial appendage aneurysm: correlation of noninvasive with clinical and surgical findings: report of a case.

Congenital left atrial appendage aneurysm is rarely diagnosed on the basis of an abnormal cardiac silhouette. Patients with a left atrial appendage aneurysm often present with symptoms of systemic emboli or supraventricular arrhythmias. A patient with left atrial appendage aneurysm was diagnosed by correlation of two noninvasive techniques echocardiography and radionuclide scintiscanning. Angiography was confirmatory and aneurysmectomy was successfully performed.     

先天性左房瘤1例报告及文献复习

先天性左房瘤是一种罕见的心脏畸形。至今国外文献仅报告４０余例，国内仅７例。我们报告１例５岁女孩术前无症状，胸片发现左心缘扩大，超声心动图明确诊断。在体外循环下行瘤体切除，治愈出院。结合文献对本病临床特点、诊断、治疗及预后进行讨论。     

Atrial septal aneurysm and stroke: a transesophageal echocardiographic study

The prevalence and morphologic characteristics of atrial septal aneurysms identified by transesophageal echocardiography in 410 consecutive patients are described. Two groups of patients were compared: Group I consisted of 133 patients referred for evaluation of the potential source of an embolus and Group II consisted of 277 patients referred for other reasons. An atrial septal aneurysm was diagnosed by transesophageal echocardiography in 32 (8%) of the 410 patients. Surface echocardiography identified only 12 of these aneurysms. Atrial septal aneurysm was significantly more common in patients with stroke (20 [15%] of 133 vs. 12 [4%] of 277) (p less than 0.05); right to left shunting at the atrial level was demonstrated in 70% of patients in Group I and 75% of patients in Group II by saline contrast echocardiography. Four patients in Group I had an atrial septal defect with additional left to right flow. There was no difference between the two groups in aneurysm base width, total excursion or left atrial or right atrial excursion. However, Group I patients had a thinner atrial septal aneurysm than did Group II patients. It is concluded that an atrial septal aneurysm occurs commonly in patients with unexplained stroke, is more frequently detected by transesophageal echocardiography than by surface echocardiography and is usually associated with right to left atrial shunting. Treatment (anticoagulant therapy vs. surgery) of atrial septal aneurysm identified in stroke patients can be determined only by long-term follow-up studies.     

Resolution of Thrombi in Left Atrial Appendage Aneurysm

Atrial appendage aneurysm is a rare cardiac disease and may be complicated by embolic events and rhythm disturbances. We describe a case of a congenital left atrial aneurysm presenting with a cere-brovascular accident in a 57-year-old female. The diagnosis was made by transesophageal echocardiography, which revealed the presence of intraaneurysmal thrombi. The patient initially received anticoagulant therapy and the thrombi were resolved. Subsequently, she was successfully operated on and the aneurysm was removed. This is the first report of thrombi resolution in a left atrial appendage aneurysm.     

Intrapericardial left atrial appendage aneurysm

An intrapericardial left atrial appendage aneurysm is described in a 36 year old female. She was asymptomatic except for intermittent palpitations. The aneurysm was initially diagnosed by 2D-echocardiogram and confirmed by pulmonary cineangiogram. In addition to compression and indentation of the anterolateral wall of the left ventricle, hypokinesis was noted, which we believe has not been reported previously, in association with the left atrial appendage aneurysm, and which improved after surgical resection. The patient is symptom-free at a 5 year follow-up. A review of the literature is presented.     

Left atrial appendage aneurysm: echocardiographic diagnostic

The left atrial appendage aneurysm is a rare condition that frequently manifests itself by heart arrhythmias or thromboembolism. We report the case of a patient with left atrial appendage aneurysm, diagnosed by echocardiography and submitted to surgical resection.     

Slow increase in the size of the left atrium with atrial fibrillation--a congenital pericardial defect or aneurysm of the left atrium?

Gradual left atrial enlargement and development of atrial fibrillation--congenital pericardial defect or left atrial aneurysm? Left atrial aneurysms are rare. Whether or not a pericardial defect is associated can be ascertained by a diagnostic left-sided pneumothorax with air entering the pericardial cavity, although a negative finding does not necessarily rule out the presence of a defect. Cardiac surgery (aneurysmectomy) is advisable if the patient develops significant symptoms or if there is a progressive increase in atrial size. A case is presented with progressively increasing left atrial aneurysm and the development of atrial fibrillation. Although a pericardial defect was postulated (from echocardiogram, MR, CT, angiogram) the pericardium was found to be intact at surgery.     

Congenital aneurysm of the left atrial appendage

Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. We report the case of a 31-year-old woman with a marked prominence of the upper left heart border at the chest X-ray in whom the diagnosis of congenital aneurysm of the left atrial appendage was confirmed by cross-sectional echocardiography and computed tomography. Up to few years ago angiography was considered the method of choice in establishing the diagnosis. Cross-sectional echocardiography has recently become a safe and reliable method for diagnosing congenital aneurysm of the left atrium and should be considered in any case with abnormality of the profile of left atrium on the chest radiography.     

Noninvasive and invasive diagnosis of a huge congenital aneurysm of the left atrium: a case report

An intrapericardial aneurysm of the left atrium in a twenty-eight-year old asymptomatic woman is reported. The aneurysm was diagnosed by two-dimensional echocardiography and the specific intraaneurysmatic flow pattern was described by color blood flow imaging. To the authors' knowledge such a noninvasive diagnosis of a left atrial aneurysm has never been reported in the literature before. The diagnosis was confirmed by angiocardiography. The aneurysm was successfully resected. The patient was discharged without medication and continues to do well.     

Diagnosis of atrial septal aneurysm by two-dimensional echocardiography--a case report.

A patient who was evaluated for a syncopal episode was found by two-dimensional (2D) echocardiography to have an aneurysm of the atrial septum. The atrial septal aneurysm appeared as a localized outpouching of the atrial septum that protruded into the left atrium during systole and into the right atrium during early diastole. The 2D echocardiography permits the definitive diagnosis of this condition by a noninvasive technique.     

Massive left atrial appendage aneurysm presenting as supraventricular tachycardia

Left atrial appendage aneurysm is a rarely reported condition. Symptoms are absent in childhood and diagnosis is usually incidental. Systemic embolization or arrhythmia can bring these cases to medical attention. We report the case of a 12-year-old male with massive left atrial appendage aneurysm who presented with effort intolerance and supraventricular arrhythmia. The diagnosis was made by transthoracic echocardiography. Magnetic resonance imaging and left atriogram were also done before surgical resection.     

Congenital aneurysm of the left atrial appendage

Congenital aneurysm of the left atrial appendage is quite infrequent.Most instances are asymptomatic. Patients can report a varietyof symptoms, one of the most frequent being onset of auriculartachyarrhythmia. Various imaging techniques are useful in diagnosisand allow the differential diagnosis with other pathologies. We describe the case of a 24-year-old male with congenital aneurysmof the left atrial appendage. The patient presented with auricularfibrillation. Diagnosis was based on transthoracic and trans-esophagealechocardiography, and the patient was treated by surgical resectionof the aneurysm under extracorporeal circulation.     

Left atrial appendage aneurysm: a rare cause of paroxysmal supraventricular tachycardia

Left atrial appendage aneurysm is a rare abnormality and a diagnostic dilemma in patients with cardiomegaly. Patients most commonly present with atrial tachyarrhythmias and thromboembolic events. Resection of the aneurysm is usually curative. We report herein the case of a 27-year-old man with massive left atrial appendage aneurysm diagnosed incidentally in the course of pre-operative evaluation for a non-cardiac surgery. The marked cardiomegaly detected in a routinely ordered pre-operative chest X-ray and the history of previous episodes of palpitation accompanied by chest discomfort guided us to the diagnosis. The diagnosis was made by transthoracic echocardiography and confirmed by angiography and then surgery.     

A rare association of aneurysm of the interatrial septum and ventricular tachycardia. Description of 2 cases

Two patients with isolated atrial septum aneurysm and ventricular tachycardia are reported. In both patients ventricular tachycardia showed left bundle branch block pattern with right axis deviation. The ventricular origin of the arrhythmia was confirmed by electrophysiological study. The aneurysm of the interatrial septum was the only detectable cardiac abnormality. The possible relationship between the atrial abnormality and ventricular tachycardia is discussed.     

Echocardiographic diagnosis of atrial septal aneurysm in an infant with hypoplastic right heart syndrome

Echocardiographic findings are described in a patient with hypoplastic right heart syndrome (pulmonary atresia type with intact ventricular septum and small right ventricular cavity) who had an associated atrial septal aneurysm. An unusual appearance of echoes behind the aorta bulging into the left atrium in diastole on both the M-mode and cross-sectional echo suggested this diagnosis prior to cardiac catheterization. The angiographic findings confirmed the diagnosis of right ventricular hypoplasia, pulmonary atresia and the large atrial septal aneurysm. The infant died after surgery and the atrial septal aneurysm was observed at autopsy. The importance of the diagnosis of the atrial septal aneurysm and its association with restriction of right-to-left atrial shunting prompts this report.     

An Unusual Cardiac Defect in a Patient with Clinical Features Overlapping Between Cardiofaciocutaneous and Noonan Syndromes

It is important to recognize the possibility of a syndromic etiology of cardiac defects when dysmorphic features and other congenital defects are present. We report a patient who presented with atrial fibrillation and was found to have an abnormal mitral valve, congenital aneurysm of the left atrial appendage, and features consistent with both Cardiofaciocutaneous syndrome and Noonan syndrome. The congenital aneurysm of the left atrial appendage was a previously unreported cardiac presentation for either syndrome. Diagnostic considerations based upon his genotype and phenotype are discussed, along with his unique cardiac presentation and treatment.     

Giant intrapericardial aneurysm of the left atrial appendage

A young patient is reported with an aneurysm of the left atrial appendage having supraventricular arrhythmias and a period of chest pain accompanied by a rise in cardiac enzymes. Compression of the left anterior descending coronary artery by the aneurysm was felt to be responsible for the myocardial injury.     

An unusual case of mitral valve aneurysm: Two dimensional echocardiographic and cineangiocardiographic features

A patient is described in whom an aneurysm of the posterior mitral leaflet caused severe mitral incompetence and cardiac failure. The aneurysm was seen as an additional echo-free space within the left atrium in the real time two dimensional echocardiogram. Both echocardiographic and cineangiocardiographic appearances were misinterpreted initially because the aneurysmal leaflet did not move into the left ventricle during diastole. This feature was explained during the successful surgical repair of the valve by the observation that the aneurysm was adherent to the left atrial wall.     

Atrial septal aneurysm: a report of three cases

Three cases of isolated atrial septal aneurysm are reported. Case 1: A 66-year-old man visited our hospital for detailed examination and evaluation of premature ventricular contractions and left ventricular hypertrophy previously detected. Echocardiography revealed an atrial septal aneurysm protruding into the left atrium in the early systolic phase and into the right atrium during the mid-systolic to diastolic phase. Subxiphoid M-mode echocardiography showed triphasic movement of the wall of the atrial septal aneurysm toward the left atrium during the end-diastolic to systolic phase, which was enhanced during inspiration. No abnormalities were found by Doppler echocardiography. Cardiac catheterization revealed normal intracardiac pressures and oxygen saturations, but a right arteriogram revealed a defect in the right atrium. Case 2: A five-month-old male infant was referred to our hospital for detailed examination and evaluation of a heart murmur. Echocardiography revealed an atrial septal aneurysm in which a part of the interatrial septum protruded into the right atrium. Case 3: A one-day-old female infant was admitted to our hospital for detailed cardiac examination. Echocardiography revealed that the entire interatrial septum protruded into the right atrium. In Cases 2 and 3 the morphology of the aneurysms did not show cyclic or respiratory change. These two cases had no other abnormalities on echocardiography or Doppler echocardiography. The mechanism of the wall movement in Case 1 seemed to be attributed to differences in pressures between the right and left atria and in properties of the aneurysmal walls. Enhancement of the protrusion of the aneurysmal wall toward the left atrium during inspiration was considered due to inspiratory increase of right atrial pressure.