Two-dimensional echocardiographic features of atrial septal aneurysms.

Gondi, Bapineedu; Nanda, Navin C.

doi:10.1161/01.cir.63.2.452

Cited by 82 publications

(31 citation statements)

References 5 publications

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“…13,14) Atrial septal aneu-rysms are associated with increased incidences of systemic and cerebrovascular embolic events. 15,16) The association of MVP and interatrial septal aneurysm appears to be particularly important in that this subset of patients has an increased likelihood of cerebrovascular embolic events. 17) Cardiac thrombosis is a rare finding of Behçet's disease.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Involvement in Behcet's Disease.

et al. 2002

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SUMMARYThe incidence and nature of cardiac involvement in Behçet's disease are not yet clearly documented. We first used transesophageal echocardiography in combination with resting and signal averaged electrocardiography to define cardiac involvement in Behçet's patients. Transthoracic and multiplane transesophageal echocardiography, and resting and signal averaged electrocardiography were performed in 35 Behçet's disease patients (9 women and 26 men, mean age: 38±12 years) and 30 normal subjects. Higher incidences of interatrial septum aneurysm (31% to 6%), mitral valve prolapse (25% to 3%), mitral regurgitation (40% to 6%) and aneurysmal dilatations of sinus valsalva and ascendan aorta were observed in the Behçet's disease patients than in the normal subjects. Mean QT dispersion and mean corrected QT dispersion values were significantly greater in the patients with Behçet's disease. Patients with interatrial septum aneurysm (and/or PFO), valvular dysfunction or proximal aorta dilatation had greater QT dispersion values than thase without these pathologies in the Behçet's group (63±11 vs 44±19 ms, 58±23 vs 41±24 and 60±27 vs 42±23 ms respectively, P<0.05). Positive signal averaged electrocardiography parameters were detected in 18 (51%) Behçet's disease patients compared with one (3%) in controls (P<0.001). Dilatation of the proximal aorta, interatrial septal aneurysm, mitral valve prolapse, and mitral regurgitation are the common findings of cardiac involvement in Behçet's disease. Increased dispersion of ventricular repolarisation and positive late potentials are also detected. QT dispersion is significantly higher in patients with these cardiac abnormalities. These findings suggest that cardiac involvement in this disorder is a diffuse process which involves both cardiac structure and vascular elements. (Jpn Heart J 2002; 43: 389-398) Key words: Echocardiography, Electrocardiography, Behçet's disease BEHÇET'S disease is known as a chronic relapsing, inflammatory process manifesting recurrent oral and genital aphthous ulcerations. Eye inflammation, skin lesions of erythema nodosum and acneiform eruptions, joint, central nervous system, large vessel and gastrointestinal system tract involvement are also seen in From the

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Involvement in Behcet's Disease.

et al. 2002

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“…12 Care was taken to differentiate these findings from a nonlocalized bulge of the entire septum 21 or from atrial structures such as tumor, thrombus, Eustachian valve, or Chiari's net. 7 " Echo contrast studies were performed by injecting agitated paraben-preserved saline solution through a 20-or 18-gauge plastic catheter inserted into an antecubital vein. 22 A shunt was defined as the appearance of contrast in the left atrium within 4 beats of its appearance in the right.…”

Section: Echocardiographic Studiesmentioning

confidence: 99%

Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events.

Belkin¹,

Hurwitz²,

Kisslo³

1987

Stroke

120

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Patient records in 36 consecutively identified patients with typical echocardiographic findings of atrial septal aneurysm were reviewed. Ten of the 36 (28%) had cerebrovascular events. Of these 10, 5 had completed strokes of definite embolic origin on the basis of clinical, angiographic, and computed tomographic findings; 2 had transient ischemic attacks of probable embolic origin. One of the 36 patients had a definite peripheral vascular embolus. Thus, 6 of 36 consecutively identified patients with atrial septal aneurysm (17%) had definite embolic events and 8 of 36 (22%) had definite or possible embolic events. The cause of the association between atrial septal aneurysm and emboli is unknown. While aneurysm-associated thrombus has been suggested, the high proportion (90%) of patients with interatrial shunting demonstrated by contrast echocardiography in this study suggests paradoxical embolization as a potential cause. Whatever its mechanism, the high prevalence of embolic events in this series strongly supports the premise that atrial septal aneurysm is a cardiac abnormality with embolic potential. (Stroke 1987; 18:856-862)

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“…ASA appear as a thin, localized outpouching of the atrial septum, protruding into the right atrium, with marked variation in contour and size during the cardiac cycle [100], In a series of 36 patients with ASA. reported by Belkin et al [101.…”

Section: Pfomentioning

confidence: 99%

Cardiac Evaluation of the Patient with Stroke

Vandenberg¹,

Biller²

1991

Cerebrovasc Dis

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Of the 400,000 new strokes in the United States each year, approximately 85% are due to cerebral infarction, and about 15% of these are from cardiogenic embolization. Emboli from cardiac sources often cause a severe neurological deficit or death. The frequency of these devastating events would likely be reduced if the offending cardiac lesions were adequately recognized and treated. Recently, noninvasive cardiac imaging has expanded our ability to obtain morphological, functional, and metabolic information of the heart and thus diagnose and assess a variety of cardiac conditions, many of which have been implicated as potential causes of cerebral embolization or hypoperfusion. These imaging techniques differ widely in the information they offer, and their use should be optimized in the pursuit of associated cardiac disease in patients with acute focal cerebral ischemia. We believe the use of two-dimensional echocardiography in older patients with focal cerebral ischemia should be limited to those with clinical clues of heart disease. Two-dimensional echocardiography should be considered in all patients younger than 45 years old with otherwise unexplained focal cerebral ischemia. Transesophageal and contrast echocardiography should be used in selected individuals, particularly when the transthoracic images are technically inadequate for the evaluation of mitral and aortic prosthetic valves or vegetations, or whenever there is need for better visualization of the left atrial appendage or interatrial septum, or when a right-to-left shunt is suspected.

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Two-dimensional echocardiographic features of atrial septal aneurysms.

Cited by 82 publications

References 5 publications

Cardiovascular Involvement in Behcet's Disease.

Cardiovascular Involvement in Behcet's Disease.

Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events.

Cardiac Evaluation of the Patient with Stroke

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