Open AccessFrequency of atrial septal aneurysm in patients with recent stroke: Preliminary results from a multicenter study
Author(s) -
Aquilina Michele,
Oldani Antonio,
Longhini Carlo,
Mattioli Giorgio,
Mattioli Anna Vittoria
Publication year - 2001
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960240408
Subject(s) - medicine , patent foramen ovale , cardiology , stroke (engine) , etiology , embolism , aneurysm , vascular disease , paradoxical embolism , population , risk factor , radiology , migraine , mechanical engineering , environmental health , engineering
Abstract Background : The role of atrial septal aneurysm (ASA) as a risk factor for cerebral ischemia of unknown etiology is controversial. Recent studies have found an association between ASA and focal ischemic events, while results from other studies suggest a low incidence of embolism in patients with ASA. Hypothesis : The present study was designed to evaluate the frequency of ASA, a minor cardioembolic source, in patients with a recent stroke presenting with normal carotid arteries. Methods : In all, 394 patients with cerebral ischemic stroke were referred to our institutions. Patients underwent transthracic and transesophageal echocardiography and carotid artery ultrasound examination. The study population included 215 patients without significant arterial disease. Frequency and morphologic characteristics of ASA were evaluated. Results : Transthoracic examination showed ASA in 39 patients (18%), while transesophageal echocardiography showed ASA in 61 patients (28%). A patent foramen ovale was found in 47 patients (21.8%) and was associated with ASA in 40 patients (65.5%). We observed an increased thickness of the aneurysmatic wall (3.80 ± 1.7 mm) in all patients with ASA. Conclusions : The present study confirms the relationship between ASA and stroke in patients with normal carotid arteries. The most common abnormality associated with ASA was patent foramen ovale. We suggest that patients who have a stroke in the absence of significant carotid disease undergo transesophageal echocardiography to identify possible underlying septal abnormalities.