Pediatric Cardiology

, Volume 40, Issue 1, pp 230–233 | Cite as

A Proposed Etiology for Atrial Tachyarrhythmia in Neonates with Atrial Septal Aneurysms

  • Raymond MoralesEmail author
  • John W. Bokowski
  • Hoang Nguyen
  • Sawsan M. Awad
Case Report


An atrial septal aneurysm (ASA) is an increasingly recognized entity that involves septal tissue significantly bulging into either atria instead of remaining in a relatively neutral position. ASAs may be described based on the length of the segment of atrial septal tissue involved as well as the distance and direction of excursion into the atria throughout the cardiac cycle. Complications associated with ASA include arrhythmias and thromboembolic events with the latter usually in the context of atrial shunting. While the presence of an ASA has been implicated in the development of atrial tachyarrhythmias, no clear mechanism has been elucidated to-date. In this case, we document one of the previously proposed mechanisms of atrial arrhythmia using echocardiography imaging.


Atrial septal aneurysm Arrhythmia Atrial tachyarrhythmia 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

246_2018_2017_MOESM1_ESM.avi (14.1 mb)
ONLINE RESOURCE 1 Transthoracic Echocardiogram (TTE) on day of life 2. Apical 4-chamber view demonstrating a floppy ASA oscillating between right and left atrium. The hypermobile atrial septum primarily bulges into the left atrium. (AVI 14402 KB)
246_2018_2017_MOESM2_ESM.avi (86.1 mb)
ONLINE RESOURCE 2 Transthoracic Echocardiogram (TTE) on day of life 2. Parasternal short axis view demonstrating a floppy ASA oscillating between right and left atrium. The atrial septum primarily bulges into the left atrium coming into direct contact with the posterior wall of the left atrium thereby inducing a premature atrial beat. (AVI 88204 KB)
246_2018_2017_MOESM3_ESM.avi (14.9 mb)
ONLINE RESOURCE 3 Transthoracic Echocardiogram (TTE) on day of life 16. Apical 4-chamber view demonstrating a floppy ASA oscillating between right and left atrium. The atrial septum primarily bulges into the right atrium for the majority of the cardiac cycle. (AVI 15302 KB)


  1. 1.
    Hanley PC, Tajik AJ, Hynes JK et al (1985) Diagnosis and classification of atrial septal aneurysm by two-dimensional echocardiography: report of 80 consecutive cases. J Am Coll Cardiol 6:1370–1382. CrossRefGoogle Scholar
  2. 2.
    Longhini C, Brunazzi MC, Musacci G et al (1985) Atrial septal aneurysm: echopolycardiographic study. Am J Cardiol 56:653–656CrossRefGoogle Scholar
  3. 3.
    Ozcelik N, Atalay S, Tutar E, Ekici F (2006) Prevalence of interatrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 27:343–346. CrossRefGoogle Scholar
  4. 4.
    Thompson JI, Phillips LA, Melmon KL (1966) Pseudotumor of the right atrium. Report of a case and review of its etiology. Ann Intern Med 64:665–667. CrossRefGoogle Scholar
  5. 5.
    Oyedeji AT, Okunola O, Sani MU (2012) Atrial septal aneurysm mimicking a cor triatriatum sinister: a case report and review of the literature. Clin Med Insights Case Rep. Google Scholar
  6. 6.
    Mattioli AV, Aquilina M, Oldani A et al (2001) Atrial septal aneurysm as a cardioembolic source in adult patients with stroke and normal carotid arteries. A multicentre study. Eur Heart J 22:261–268. CrossRefGoogle Scholar
  7. 7.
    Rice MJ, McDonald RW, Reller MD (1988) Fetal atrial septal aneurysm: a cause of fetal atrial arrhythmias. J Am Coll Cardiol 12:1292–1297CrossRefGoogle Scholar
  8. 8.
    Toro L, Weintraub RG, Shiota T et al (1994) Relation between persistent atrial arrhythmias and redundant septum primum flap (atrial septal aneurysm) in fetuses. Am J Cardiol 73:711–713. CrossRefGoogle Scholar
  9. 9.
    Hauser AM, Timmis GC, Stewart JR et al (1984) Aneurysm of the atrial septum as diagnosed by echocardiography: Analysis of 11 patients. Am J Cardiol 53:1401–1402. CrossRefGoogle Scholar
  10. 10.
    Mattioli AV, Bonetti L, Aquilina M et al (2003) The association between atrial septal aneurysm and mitral valve prolapse in patients with recent stroke and normal carotid arteries. Ital Heart J 4:602–606Google Scholar
  11. 11.
    Freedom RM, Rowe RD (1976) Aneurysm of the atrial septum in tricuspid atresia: diagnosis during life and therapy. Am J Cardiol 38:265–267CrossRefGoogle Scholar
  12. 12.
    Sahn DJ, Allen HD, Anderson R, Goldberg SJ (1978) Echocardiographic diagnosis of atrial septal aneurysm in an infant with hypoplastic right heart syndrome. Chest 73:227–230. CrossRefGoogle Scholar
  13. 13.
    Mügge A, Daniel WG, Angermann C et al (1995) Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography. Circulation 91:2785–2792.;01.CIR.91.11.2785 CrossRefGoogle Scholar
  14. 14.
    Olivares-Reyes A, Chan S, Lazar EJ et al (1997) Atrial septal aneurysm: a new classification in two hundred five adults. J Am Soc Echocardiogr 10:644–656CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric Cardiology, Department of PediatricsRush University Medical CenterChicagoUSA

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