eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2016-04-18 4 3 111 114 10.12691/ajmcr-4-3-10 AJMCR20164310 article Pramod Theetha Kariyanna drtkpram@gmail.com 1 Apoorva Jayarangaiah 2 Robert Adrah 3 Abhishek Sharma 4 Department of Internal Medicine, State University of new York, Downstate Medical Center, U.S.A. Department of Internal Medicine, Marshfield Clinic- St Joseph Hospital, Marshfield, Wisconsin, U.S.A. Department of Internal Medicine, Brookdale University Hospital and Medical center, Brooklyn, New York, U.S.A. Division of Cardiology, Department of Internal Medicine, State University of New York, Downstate Medical center, Brooklyn, New York, U.S.A. Atrial septum aneurysm (ASA) is a saccular aneurysm of the interatrial septum, bulging into either atrium during the cardiac cycle. It is mostly congenital in natures and is often associated with patent foramen ovale (PFO). ASA is increasingly gaining attention as a possible cause of cryptogenic stroke. We here present a case of ASA in an elderly female in whom ASA possibly contributed to atrial fibrillation and mitral valvular prolapse; she denied any thromboembolic event. Transesophageal echocardiography remains the imaging modality of choice for diagnosis of ASA. Management guidelines for initiation of antiplatelet therapy, anticoagulation and the need for endovascular or surgical closure of associated PFO are lacking. http://pubs.sciepub.com/ajmcr/4/3/10/ajmcr-4-3-10.pdf atrial septum aneurysm patent foramen ovale stroke transesophagel echocardiography