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Archives of cardiovascular diseases
Volume 103, n° 10
pages 559-560 (octobre 2010)
Doi : 10.1016/j.acvd.2010.01.011
Received : 16 December 2009 ;  accepted : 28 January 2010
Aneurysm of right atrial appendage in a young patient
Anévrisme de l’auricule droit chez un jeune patient
 

Florent Le Ven , Erwan Orhan, Yannick Jobic
Department of Cardiology, Brest University Hospital, CHU de la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex, France 

Corresponding author. Fax: +33 02 98.34.73.93.

Keywords : Aneurysm, Atrial appendage, Congenital, Echocardiography

Mots clés : Anévrisme, Auricule, Congénital, Échographie cardiaque


A 16-year-old youth was admitted to our cardiology department because of echocardiographic evidence of an aneurysmal cavity close to the right atrium. The patient was asymptomatic, and was referred initially for a cardiac murmur assessment; he had no personal or family history of cardiac disease, trauma or other illness. Physical examination was unremarkable except for isolated, mild, cardiac systolic murmur. The standard 12-lead electrocardiogram displayed a sinus rhythm without abnormalities, even in P wave morphology.

Plain chest X-ray showed enlargement of the cardiac silhouette with normal pulmonary vasculature. Transthoracic echocardiography demonstrated a thin-walled cavity (5×3cm) in continuity with the right atrium, bounded by an incomplete diaphragm set between the bottom of the right atrium and just above the tricuspid valve. The lateral side of tricuspid valve annulus was displaced into the centre of the right ventricular basis (Figure 1, Figure 2). Cardiovascular magnetic resonance imaging confirmed a huge dilatation of the right atrium and showed a “paper thin” wall (Figure 3, Supplementary data, see videos 1 and 2). No other morphological or Doppler abnormalities were found. No abnormal venous return in the right atrium, atrial septal defect, venous coronary sinus dilatation, patent foramen ovale, spontaneous contrast or thrombi were demonstrated.



Figure 1


Figure 1. 

Apical four-chamber view in transthoracic echocardiography, showing the right atrial appendage aneurysm (A). Right atrium (B) and right ventricle (C) size were normal. The lateral side of the tricuspid valve annulus was displaced into the centre of the right ventricular basis (D).

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Figure 2


Figure 2. 

Echocardiographic off-axis parasternal view. A. Right atrium appendage aneurysm. B. Right atrium. C. Right ventricle. D. Tricuspid valve.

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Figure 3


Figure 3. 

Magnetic resonance imaging four-chamber view. A. Right appendage aneurysm. B. Right atrium. C. Right ventricle.

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In order to detect supraventricular arrhythmia, a 24-hour Holter recording was obtained, which was normal. As the patient was asymptomatic, no specific treatment was initiated. Annual cardiology follow-up was scheduled.

Conflict of interest statement

None.


Appendix A. Supplementary data

Click here to download the file (1.84 Mo)
 Videos 1 and 2-1 
Click here to download the file (3.03 Mo)
 Videos 1 and 2-2 
Videos 1 and 2. 

Dynamic cardiac magnetic resonance views.



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