Two case reports of right atrial aneurysm


Li HP, Ye XW, Wang HT.

Medicine (Baltimore). 2020 Apr;99(16):e19748. doi: 10.1097/MD.0000000000019748.

PMID: 32311971 Free Article

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Introduction: Right atrial aneurysm (RAA) is a rare congenital heart disease (CHD) that usually shows no symptom and is discovered occasionally. This paper introduces the clinical and imaging data obtained in 2 RAA patients and presents a related literature review with the aim of increasing understanding of this disease.

Patient focus: One case showed chest distress, while the other showed symptoms on physical examination and positive signs.

Diagnosis: Both of these 2 cases were diagnosed with RAA based on ultrasonography, computed tomography angiography (CTA), and enhanced magnetic resonance imaging (MRI) examinations.

Interventions: One patient was orally administered warfarin anticoagulant therapy, while the other was given amiodarone to control arrhythmia as well as warfarin anticoagulant therapy.

Results: The clinical symptoms of both cases were not aggravated.

Conclusions: RAA is a rare cardiac anomaly that can induce severe complications, and it is mainly diagnosed based on imaging examinations. Conservative treatment and regular imaging monitoring are recommended for asymptomatic patients with no high-risk factors, while surgical treatment should be performed in symptomatic patients with high-risk factors.



Figure 1 Ultrasonography, MR, and enhanced CT images obtained in case 1. (a) Ultrasonography revealed a cystic mass in the right edge of the heart, which was connected to the right atrium; (b) a diverticular lesion was seen inside the pericardium and found to be connected to the right atrium and to have a thin wall; (c and d) well-defined enhancement was observed in the localized extraneous lesion in the right atrium area, and a 3D image showed no external compressive structure in the adjacent coronary artery.


Figure 2 Ultrasonography and enhanced CT images obtained in case 2. (a) An ultrasound image revealed a cystic mass that connected the right edge of the heart with the right atrium. (b and c) Coronal and axial enhanced CT images revealed an oval-shaped diverticular lesion in the right atrium that had a thin wall and was connected to the right atrium. (d) A 3D image revealed no abnormality in the adjacent coronary artery.