Atrial Septal Aneurysm in Adult Patients of Therapeutic Hospital
https://doi.org/10.20996/1819-6446-2019-15-4-518-523
Abstract
Aim. To study detection of atrial septal aneurysm (ASA) by transthoracic echocardiography in patients of the older age group of the therapeutic hospital, as well as combinations with other structural disorders of the heart and blood vessels, as well as other signs of congenital connective tissue dysplasia (CCTD) of other localization.
Material and methods. Identification of ASA as well as other signs of CCTD was performed in patients ≥40 years hospitalized due to exacerbation of therapeutic diseases (n=1119), which had transthoracic echocardiography.
Results. ASA was found in 1.34% of patients (n=15). Undifferentiated connective tissue dysplasia was diagnosed in 14 (93.3%) ASA patients. Prolapse of mitral (60%), tricuspid (33.3%) or both atrio-ventricular valves of the heart (6.7%), patent foramen ovale (33.3%), rudimentary Eustachian valve (6.7%), additional ventricle chords (13.3%), Valsalva sinus dilation (6.7%) was found in ASA patients. 14 (93.3%) patients had electrocardiography signs of cardiac rhythm and conduction disorders. Chronic venous insufficiency (100%), disorders of the musculoskeletal system (100%), hiatal hernia (40%), anterior abdominal wall hernia (46.7%), nephroptosis (46.7%), kidney cysts (33.3%) intestinal diverticula and dolichosigma (26.7%), bronchiectasis (6.7%) were also found.
Conclusion. ASA was found in 1.34% of patients in a therapeutic hospital ≥40 years. Clinically significant and prognostically unfavorable CCTDs were not found in ASA patients in this study. However, physicians should consider the possibility of the presence of other abnormalities of the heart and large vessels, as well as other systems and organs that can lead to fatal events, in these patients.
About the Authors
O. V. RyazantsevaRussian Federation
Olga V. Ryazantseva – MD, PhD, Associate Professor, Chairof Clinical Pharmacology and Propaedeutics of Internal Medicine
Trubetskaya ul. 8-2, Moscow, 119991
N. I. Lenkova
Russian Federation
Nadezhda I. Lenkova – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine
Trubetskaya ul. 8-2, Moscow, 119991
O. D. Ostroumova
Russian Federation
Olga D. Ostroumova – MD, PhD, Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine
Trubetskaya ul. 8-2, Moscow, 119991
E. V. Shikh
Russian Federation
Evgenia V. Shikh – MD, PhD, Professor, Head of Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Director of the Institute of Professional Education
Trubetskaya ul. 8-2, Moscow, 119991
S. M. Rykova
Russian Federation
Svetlana M. Rykova – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine
Trubetskaya ul. 8-2, Moscow, 119991
References
1. Abdullaev R.Y., Sobol Y.S., Schiller N.B., Foster E. Modern echocardiography. Kharkiv: Fortuna Press; 1998 (In Russ.).
2. Rudoy A.S., Bova A.A., Nekhaychik T.A. Genetic aortopathies and structural anomalies of the heart. Moscow: GEOTAR-Media; 2017 (In Russ.).
3. Feed L.A., Lovy D., Levine R.A. et al. Mitral valve prolapse and atrial septal aneurysm: an evaluation in the Framingham. Am J Cardiol. 2002;89(11):1326-9. DOI:10.1016/S0002-9149(02)02340-8.
4. Nechaeva G.I., Martynov A.I. Connective tissue dysplasia: cardiovascular changes, modern approaches to diagnosis and treatment. Moscow: Medical Information Agency; 2017 (In Russ.).
5. Yetkin E., Atalay H., Ileri M. Atrial septal aneurysm: Prevalence and covariates in adults. Int J Cardiol. 2016;223:656-9. DOI:10.1016/j.ijcard.2016.08.220.
6. Jatav R.K., Kumbhare M.B, Surender T., et al. Atrial septal aneurysm in adult patients: spectrum of clinical, echocardiographic presentation and to propose a new classification on the basis of transthoracictwo-dimensional echocardiography. IJRMS. 2014;2(2):708-17.
7. Olivares-Reyes A., Chan S., Laser E.J., et al. Atrial septal aneurysm: a new classification in two hundred five adults. J Am Soc Echocardiogr. 1997;6:644-56.
8. Rybakova M.K., Alekhin M.N., Mitkov V.V. A practical guide to ultrasound diagnostics. Echocardiography. 2nd edition. Moscow: Vidar; 2008 (In Russ.).
9. Rybakova M.K., Mitkov V.V. Echocardiography in tables and diagrams. Moscow: Vidar; 2011 (In Russ.).
10. Vorobiev L.P., Gribkov I.P., Petrusenko I.M., et al. The relationship of the syndrome of early repolarization of the ventricles, mitral valve prolapse and additional chordial ventricle. Kardiologiia. 1991;31(9):106-9 (In Russ.).
11. Bukalli A., Kamberi L., Pllana E., Gashi A. Atrial septal aneurysm associated with additional cardiovascular comorbidities in two middle age female patients with ECG signs of right bundle branch block: two case reports. Cases J. 2008:l(1):51. DOI:10.1186/1757-1626-1-51.
12. Zemtsovskiy E.V., Malev E.G. Minor abnormalities of the heart and dysplastic phenotypes. St. Petersburg: IWESEP; 2012 (In Russ.).
13. Druk I.V., Smyalovsky V.E., Troyan V.V., et al. Dysplasia of the connective tissue in patients with intracranial arterial aneurysms and arteriovenous malformations. Siberian Medical Journal. 2011;26(3):37-41 (In Russ.).
14. Druk I.V., Nechaeva G.I., Oseeva O.V. et al. Personalized cardiovascular complications in young patients with connective tissue dysplasia. Kardiologiia. 2015;55(3):75-84 (In Russ.).
15. Kravtsov Y.A., Yavorskaya M.V. Clinical signs of dysplasi-connective tissue in patients of different ages with surgical pathology. Scientific Review. Medical Sciences. 2017;(5):49-57 (In Russ.).
16. Konev V.P., Nechaeva G.I., Viktorova I.A. Detection of predictors of early and sudden death in connective tissue dysplasia as the basis for its prevention. Kardiologiia. 2006;46(4):18-25 (In Russ.).
17. Nagornaya N.V., Kartashova O.S., Dubova A.V. The relationship of cardiac rhythm disturbances and conduction with the cardiac manifestations of connective tissue dysplasia syndrome in children. University Clinic. 2006;2(1):68-72 (In Russ.).
18. Burger A.J., Sherman H.B., Charlamb M.J. Low incidence of embolic strokes with atrial septal aneurisms: a prospective, long-term study. Am Heart J. 2000;139(1):149-52. DOI:10.1016/S0002-8703(00)90322-3.
19. Shilova M.A., Konev A.P., Tsaregorodtsev A.G. Vascular pathology in persons with connective tissue dysplasia in the aspect of sudden death. Kazan Medical Journal. 2007;88(5):33-5 (In Russ.).
Review
For citations:
Ryazantseva O.V., Lenkova N.I., Ostroumova O.D., Shikh E.V., Rykova S.M. Atrial Septal Aneurysm in Adult Patients of Therapeutic Hospital. Rational Pharmacotherapy in Cardiology. 2019;15(4):518-523. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-4-518-523