- Email: [email protected]
DOUBLE ATRIAL SEPTUM: UNCOMMON ANOMALY PRESENTING WITH A COMMON SYMPTOM
1086 JACC April 5, 2016 Volume 67, Issue 13
FIT Clinical Decision Making DOUBLE ATRIAL SEPTUM: UNCOMMON ANOMALY PRESENTING WITH A COMMON SYMPTOM Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m. Session Title: FIT Clinical Decision Making: Congenital Heart Disease, Valvular Heart Disease, Pulmonary Hypertension Abstract Category: Congenital Heart Disease Presentation Number: 1152-275 Authors: Brett A. Bennett, Ervin Fox, Michael McMullan, Alfred G. Hutcheson, Michael Hall, University of Mississippi Medical Center, Jackson, MS, USA
Background: Double atrial septum (DAS) refers to dual septal structures with a potential space formed between the two that is separated from both the right and left atria. This anomaly is rarely described and can present a challenge when encountered.
Case: A 71 year-old male with a history of hypertension presented to the cardiology clinic with palpitations. Transthoracic echocardiography revealed a possible mass in the left atrium concerning for myxoma (Figure A-B). To better characterize the mass, the patient underwent cardiac MRI which demonstrated a mobile structure in the left atrium that appeared to be tethered to the atrial septum (Figure C) and was characterized as a “redundant atrial septum.” The patient then underwent transesophageal echocardiography which demonstrated the presence of a highly mobile and thin walled, additional septum primum protruding into the left atrium consistent with a DAS (Figure D-F). Color Doppler demonstrated flow into this space from the left atrium but no flow across the second septal structure into the right atrium. Agitated saline injection was negative for a right to left shunt. Decision Making: Double atrial septum has been associated with thromboembolization and some recommend therapeutic anticoagulation. Our patient had no thromboembolic events or other indication for anticoagulation so he was only placed on aspirin. Conclusions: This case represents a rare cardiac anomaly of which the etiology and clinical ramifications remain unclear.
FIT Clinical Decision Making DOUBLE ATRIAL SEPTUM: UNCOMMON ANOMALY PRESENTING WITH A COMMON SYMPTOM Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m. Session Title: FIT Clinical Decision Making: Congenital Heart Disease, Valvular Heart Disease, Pulmonary Hypertension Abstract Category: Congenital Heart Disease Presentation Number: 1152-275 Authors: Brett A. Bennett, Ervin Fox, Michael McMullan, Alfred G. Hutcheson, Michael Hall, University of Mississippi Medical Center, Jackson, MS, USA
Background: Double atrial septum (DAS) refers to dual septal structures with a potential space formed between the two that is separated from both the right and left atria. This anomaly is rarely described and can present a challenge when encountered.
Case: A 71 year-old male with a history of hypertension presented to the cardiology clinic with palpitations. Transthoracic echocardiography revealed a possible mass in the left atrium concerning for myxoma (Figure A-B). To better characterize the mass, the patient underwent cardiac MRI which demonstrated a mobile structure in the left atrium that appeared to be tethered to the atrial septum (Figure C) and was characterized as a “redundant atrial septum.” The patient then underwent transesophageal echocardiography which demonstrated the presence of a highly mobile and thin walled, additional septum primum protruding into the left atrium consistent with a DAS (Figure D-F). Color Doppler demonstrated flow into this space from the left atrium but no flow across the second septal structure into the right atrium. Agitated saline injection was negative for a right to left shunt. Decision Making: Double atrial septum has been associated with thromboembolization and some recommend therapeutic anticoagulation. Our patient had no thromboembolic events or other indication for anticoagulation so he was only placed on aspirin. Conclusions: This case represents a rare cardiac anomaly of which the etiology and clinical ramifications remain unclear.