Interatrial septal disorders, which include:
atrial septal defect, patent foramen ovale and
atrial septal aneurysm, are frequent congenital
anomalies found in adult patients. Early detection
of these anomalies is important to prevent
their hemodynamic and/or thromboembolic
consequences. The aims of this study were: to
assess the association between impulse conduction
disorders and anomalies of interatrial
septum; to determine the prevalence of different
types of interatrial septum abnormalities; to
assess anatomic, hemodynamic, and clinical
consequences of interatrial septal pathologies.
Fifty-three adult patients with impulse conduction
disorders and patients without ECG
changes but with signs of interatrial septal
abnormalities, who were referred to our center
for echocardiography, were included in a
prospective transesophageal echocardiography
study. Intera trial septal anomalies were detected
in around 85% of the examined patients.
Patent foramen ovale was encountered in 32% of the patients, and in combination with atrial septal aneurysm in an additional 11.3% of cases. Atrial septal aneurysm and atrial septal defect were diagnosed with equal frequency in 20.7% of our study population. Impulse conduction disorders were significantly more suggestive of interatrial septal anomalies than clinical signs and symptoms observed in our patients (84.91% vs 30.19%, P=0.002). Right bundle branch block was the most frequent impulse conduction disorder, found in 41 (77.36%) cases. We conclude that interatrial septal anomalies are highly associated with impulse conduction disorders, particularly with right bundle branch block. Impulse conduction disorders are more indicative of interatrial septal abnormalities in earlier stages than can be understood from the patient’s clinical condition.
Atrial septal defect, patent foramen ovale, atrial septal aneurysm, right bundle branch block.
May 10, 2011
June 01, 2011
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