Why the study?
Lipomatous atrial septal hypertrophy is usually an incidental benign finding, but it can become clinically significant by compromising venous return, impairing diastolic filling, or predisposing to atrial tachyarrhythmias.
Highlights a case of giant lipomatous atrial septal hypertrophy discovered incidentally via transesophageal echocardiography without causing hemodynamic compromise or arrhythmias.
Giant lipomatous atrial septal hypertrophy may remain asymptomatic; leaves open questions on surveillance in rare, incidental cases.
Lipomatous atrial septal hypertrophy (LASH) is a histological cardiac benign lesion finding with high prevalence in healthy population, usually detected during imaging procedures for other indications. Nevertheless, it could become clinically significant if it compromises venous return and diastolic left ventricular filling, up to becoming an anatomical substrate for atrial tachyarrhythmias. We present a case of LASH diagnosed in a 54-year-old female patient admitted to our emergency department after ground fall and collateral finding of positive blood cultures leading to transesophageal echocardiography. A giant mass involving the interatrial septum was observed, in the absence of primitive neoplasia evidence after performing a total-body computed tomography scan and abdominal echography. No signs or symptoms of pulmonary venous congestion were observed, and no relevant tachyarrhythmias were detected at continuous electrocardiogram monitoring during the hospitalization period.
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Ianni et al. (2023) studied this question.
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