Different faces of atrial septal aneurysm

Atrial septal aneurysm (ASA) is a well-recognised abnormality on the echocardiogram with a prevalence rate of 2–3%. It is a mobile, localised saccular deformity of the atrial septum and is defined as excursion of the septal tissue of greater than 10 mm from the plane of the atrial septum into either atrium or a combined excursion of 15 mm.1 ASA may be isolated or associated with another anomaly such as patent foramen ovale, atrial septal defect and mitral valve prolapse. Clinical significance of ASA remains unclear but several reports suggest possible link with atrial arrhythmias, increased prevalence of cryptogenic stroke and other embolic events.