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Atrial Septal Aneurysm

An atrial septal aneurysm is a rare malformation in your heart. People with this condition are born with extra tissue that sticks out from the wall between their heart’s two upper chambers (atria). The excess tissue sticks out into one or both upper heart chambers during your heart’s pumping and relaxing cycle. For many, it doesn’t cause issues.

Overview

What is an atrial septal aneurysm?

An atrial septal aneurysm is a congenital (present at birth) anomaly of your heart. When present, it means there’s extra tissue in the wall that separates the two upper chambers (atria) of your heart. Sometimes, this extra tissue is visible on an echocardiogram.

Experts also call it an interatrial septal aneurysm.

In many cases, an atrial septal aneurysm doesn’t interfere with blood moving through your heart or require treatment. Estimates of how many people have this condition vary, but it’s a relatively rare condition. 

Types of atrial septal aneurysms

There are five types of atrial septal aneurysms:

  • 1R: Sticks out into your right atrium.
  • 2L: Sticks out into your left atrium.
  • 3RL: Moves mostly toward your right atrium but also a little toward your left atrium.
  • 4LR: Moves mostly toward your left atrium but also a little toward your right atrium.
  • 5: Moves both directions (toward your right and left atria) equally.
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Symptoms and Causes

What symptoms are associated with atrial septal aneurysm?

Atrial septal aneurysms — which providers may find on a routine echocardiogram — are most often without symptoms. If you have symptoms, they may be from an associated finding like arrhythmias, blood clots or patent foramen ovales (PFOs). Symptoms may include:

What causes an interatrial septal aneurysm?

Researchers don’t fully understand what causes an interatrial septal aneurysm. Some researchers think genetics or a connective tissue flaw may play a role.

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What are the complications of atrial septal aneurysm?

Atrial septal aneurysm may be associated with an increased risk of:

Diagnosis and Tests

How is an atrial septal aneurysm diagnosed?

A healthcare provider can use an echocardiogram to check for an atrial septal aneurysm. They may diagnose the condition if they see extra septal tissue that bulges more than 10 millimeters (some say 15 mm) beyond the atrial wall.

If a provider needs a better look, they can use transesophageal echocardiogram (TEE). This type of test, which puts a device down your esophagus, can show the whole atrial wall. That allows providers to find atrial septal aneurysms that a traditional (transthoracic) echocardiogram (TTE) can miss. A TTE moves a device across the skin on the left side of your chest. 

Often, people don’t know they have an interatrial septal aneurysm until they have an echocardiogram for another reason. Providers may also see this condition in results from heart imaging like:

If a healthcare provider finds that you have an atrial septal aneurysm, they may want to check for other related heart issues. This is because people with this condition often have other heart conditions as well.

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Management and Treatment

What is the treatment for interatrial septal aneurysm?

You may not need any treatment if you don’t have any other heart issues or risk factors for blood clots that could lead to a stroke.

Healthcare providers may prescribe medicine for some people. Interatrial septal aneurysm treatment may include blood-thinning medications like anticoagulants or antiplatelets. This is because people with this condition can have blood clots.

Some people may need a patent foramen ovale (PFO) closure, a minimally invasive procedure. This can reduce their risk of stroke. After the procedure, you may need to take antiplatelets for a few months or even for life (if you have a stroke history).

Rarely, people need surgery to remove the atrial septal aneurysm.

Outlook / Prognosis

How serious is an interatrial septal aneurysm?

An interatrial septal aneurysm in itself isn’t a cause for concern. But if you have other factors that put you at risk for stroke, you need to take an interatrial septal aneurysm seriously.

Outlook for atrial septal aneurysm

People with an interatrial septal aneurysm appear to have a normal life expectancy. Of course, every situation is different. You may have other medical issues that affect your life expectancy.

Living With

How do I take care of myself?

Your healthcare provider may prescribe medicine to help prevent a stroke. It’s important to take this medicine for as long as your provider tells you to — and in the amount they recommend. Don’t stop taking medicine without talking to your provider first.

If you have a procedure or surgery, your provider will want to see you for regular follow-up appointments. This may include repeat imaging tests.

When should I go to the ER?

Get immediate medical attention if you or someone you’re with has stroke symptoms. These may include:

  • Trouble speaking.
  • Weakness on one side of your body.
  • Dizziness.
  • Blurry vision.
  • Sudden loss of one or more senses.
  • Confusion.
  • Severe headache.

What questions should I ask my doctor?

Questions you may want to ask your provider include:

  • Do I need treatment for my atrial septal aneurysm?
  • How often do I need follow-up appointments with you?
  • Do I have other heart issues in addition to an atrial septal aneurysm?
  • What’s the outlook for my specific situation?

A note from Cleveland Clinic

An atrial septal aneurysm diagnosis may take you by surprise, especially if you don’t have symptoms. In many cases, it’s not a cause for worry. But if it puts you at a higher risk of a stroke, talk with your healthcare provider about a plan to protect yourself. For more peace of mind, teach your loved ones and co-workers the warning signs of stroke. Knowing the signs may help you or someone else in the future.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 01/30/2024.

Learn more about our editorial process.

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