Aneurysmal 'pepper-pot' atrial septal defect in an older gentleman with multiple cerebrovascular attacks

BMJ Case Rep. 2012 Apr 28:2012:bcr1220115402. doi: 10.1136/bcr.12.2011.5402.

Abstract

Our patient presented to a large university teaching hospital with a history of light-headedness, falls and multiple cerebrovascular ischaemic events. This caused a right sided hemiplegia and the patient experienced significant functional limitation. Extensive investigations were carried out to exclude any causative factors such as carotid artery disease and the patient had all identifiable cardiovascular risk factors identified and modified. No significant pathology was found and a referral was made to the cardiology service. Transthoracic echocardiography revealed a complex type 3 perforate 'pepper pot' atrial septal aneurysm with associated thrombus. The patient was commenced on warfarin and appropriate rate limiting medication. After discussion of all interventional modalities, the patient opted for conservative management.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Contrast Media
  • Diagnosis, Differential
  • Echocardiography, Doppler
  • Heart Septal Defects, Atrial / complications*
  • Heart Septal Defects, Atrial / diagnostic imaging*
  • Heart Septal Defects, Atrial / physiopathology
  • Humans
  • Ischemic Attack, Transient / diagnostic imaging*
  • Ischemic Attack, Transient / etiology*
  • Ischemic Attack, Transient / physiopathology
  • Male

Substances

  • Contrast Media