This case demonstrates that spontaneous idiopathic right atrial rupture can rarely present asymptomatically and patients may survive without immediate surgical intervention, although surgery remains the recommended treatment.
Should not yet change practice; hypothesis-generating for asymptomatic survival without surgery in rare atrial rupture.
Atrial rupture is a very rare and fatal condition and has been only scantily reported in the past. Patients with this condition present with significant clinical symptoms requiring an urgent medical management. Case Report: In the present study we report a case of spontaneous idiopathic right atrial rupture detected on routine physical examination in a completely asymptomatic active young man. A defect of 18 mm in the right atrial wall just above the level of tricuspid valve was revealed in the transthoracic echocardiogram. Patient denied the option of surgical repair and remains asymptomatic during a two year follow-up. Conclusion: Very rarely, patients with spontaneous idiopathic right atrial rupture may remain asymptomatic for a long period and can live a normal life without any active surgical intervention. However, the patient may develop severe right heart failure followed by death if the medical condition is left untreated. In view of the long term complications, it is advisable to treat this condition with immediate surgical intervention.
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Otaal et al. (2015) studied this question.
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