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Abnormalities of the Interatrial Septum as a Potential Cardiac Source of Embolism:
Author(s) -
KICHURA GEORGE M.,
CASTELLO RAMON
Publication year - 1993
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1993.tb00055.x
Subject(s) - medicine , patent foramen ovale , interatrial septum , cardiology , fossa ovalis , paradoxical embolism , cerebral embolism , stroke (engine) , embolism , prospective cohort study , aneurysm , radiology , atrial fibrillation , left atrium , migraine , mechanical engineering , engineering
Stroke is a common and often devastating medical condition for the inflicted patient and his/her family. Certain abnormalities of the interatrial septum have recently been considered as potential causes for cerebral ischemic events. These abnormalities include atrial septal aneurysm (ASA) and patent foramen ovale (PFO). ASA is described as a bulging of the interatrial septum involving the region of the fossa ovalis. The prevalence of ASA is higher in patients undergoing transesophageal echocardiography (TEE) due to unexplained cerebral ischemia (15%) when compared to that of patients who had TEE performed for other reasons (4%). This apparently strong association between ASA and cerebral embolism has led to the consideration of ASA as a potential source of embolism. TEE appears to be more sensitive than transthoracic echocardiography (20% vs 6%) in detecting PFO. As with ASA, the prevalence of PFO is higher in those patients referred for unexplained cerebral ischemia than in those undergoing transesophageal studies for other reasons. Although a strong association between ASA, PFO, and stroke has been shown, the prognostic implications of these abnormalities are unclear. Therefore, longitudinal, prospective, and large scale studies are needed to evaluate the prognosis and clinical significance of these abnormalities.