Atrial Septal Aneurysm in an 80-year-old Woman

Atrial septal aneurysm usually complicates a patent foramen ovale and atrial septal defect. An 80-year-old female presented with two weeks symptoms of chest infection. Examination revealed consolidation in the right lower zone posteriorly in the chest, a third heart sound (S3) and hepatomegaly. Sputum microscopy and culture were unremarkable and the chest radiograph revealed a mild cardiomegaly (CTR 0.53) and consolidation in the right lower zone. Echocardiography revealed an ejection fraction af 36.5% and fractional shortening of 17.6%, displacement of the middle portion of the inter-atrial septum into the left and right atria (the defect was 1.6cm) and the displacement was more than 10 mm. Atrial septal aneurysm is known to be a risk factor for cardiac failure and cerebrovascular events in middle aged and elderly individuals.