Key result
Urgent embolectomy with anticoagulation resolves acute upper-extremity ischemia from an isolated atrial septal aneurysm.
Why the study?
Atrial septal aneurysm is a rare cardiac anomaly commonly associated with a patent foramen ovale and implicated in cardioembolic events, particularly cryptogenic strokes, while presentation via peripheral arterial embolism without a PFO is exceptional.
Case Report (n=1)
No
This case report highlights that an isolated atrial septal aneurysm without a patent foramen ovale or arrhythmia can cause peripheral arterial embolism presenting as acute upper limb digital ischemia, successfully managed with surgical embolectomy and lifelong anticoagulation.
Answers are grounded in this paper and cite their sources.
Isolated atrial septal aneurysm merits consideration in unexplained digital ischemia; leaves open its embolic prevalence and optimal management.
Background: Atrial septal aneurysm (ASA) is a rare cardiac anomaly characterized by a saccular deformity of the interatrial septum, often discovered incidentally. It is commonly associated with a patent foramen ovale (PFO) and has been implicated in cardioembolic events, particularly in cryptogenic strokes. Case presentation: We report the case of a 35-year-old male with no significant medical history, who presented with progressive pain, pallor, and cyanosis of the fingers of his left hand. Vascular imaging revealed complete thrombosis of the radial and ulnar arteries. Cardiac investigations identified an isolated ASA without any PFO or arrhythmia. The patient underwent urgent surgical embolectomy and was initiated on lifelong anticoagulation therapy. Postoperative evolution was favorable, with clinical improvement observed at three-month follow-up. Conclusion: This case highlights an exceptional presentation of ASA, revealing itself through peripheral arterial embolism in the absence of a PFO. It underlines the potential thromboembolic risk associated with isolated ASA and the importance of considering this diagnosis even in unusual ischemic presentations.
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Lahlou et al. (2026) conducted a case report in Digital ischemia secondary to an isolated atrial septal aneurysm (ASA) (n=1). Fogarty catheter surgical embolectomy and lifelong anticoagulation (unfractionated heparin bridged to vitamin K antagonists) was evaluated on Clinical resolution of digital ischemia and limb salvage. Urgent Fogarty embolectomy and anticoagulation resolved left-hand digital ischemia at 3 months in a 35-year-old male with radial and ulnar thrombosis from an isolated atrial septal aneurysm.
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