Case Reports in Pediatrics

Case Reports in Pediatrics / 2016 / Article

Case Report | Open Access

Volume 2016 |Article ID 8616918 |

Helen Bornaun, Elif Yartaşı Tik, Gonca Keskindemirci, Ali Ekiz, Kazım Öztarhan, Reyhan Dedeoğlu, Merih Çetinkaya, "Right Atrial Appendage Aneurysm in a Newborn Diagnosed with Fetal Echocardiography", Case Reports in Pediatrics, vol. 2016, Article ID 8616918, 3 pages, 2016.

Right Atrial Appendage Aneurysm in a Newborn Diagnosed with Fetal Echocardiography

Academic Editor: Larry A. Rhodes
Received01 Jul 2016
Accepted16 Aug 2016
Published15 Sep 2016


Right atrial appendage aneurysm is a very rare condition which can be asymptomatic or can cause arrhythmia or life-threatening thromboembolism. We report a case of newborn with right atrial appendage aneurysm who was diagnosed with fetal echocardiography. Anticoagulant therapy was applied to prevent thromboembolism and he is still going on follow-up without any complaint.

1. Introduction

Right atrial appendage (RAA) aneurysm is a very rare condition. Most of the RAA aneurysms are congenital but genetic predisposition has not been confirmed [1]. It is important because of its complications such as arrhythmia and life-threatening systemic and pulmonary thromboembolism [2]. We herein reported a case of neonate who was diagnosed with right atrial appendage aneurysm at 21 weeks of gestation and was reported to point out the importance of early approach to RAA aneurysm for prevention of thromboembolism.

2. Case

The newborn male infant who was born at 39 weeks of gestation by caesarean section was referred to the cardiology department because of the aneurysmal dilatation of the right atrium (RA) which was detected in the 21st week of gestation (Figure 1). During pregnancy, she had neither hydrops fetalis nor heart failure. The infant was in good condition with stable vitals on physical examination. On chest auscultation, the heart beats were rhythmic, and there was good bilateral ventilation. There was a normal sinus rhythm without other anomalies on electrocardiogram. On the other hand, the chest radiograph showed enlargement of the cardiac silhouette (Figure 2).

Transthoracic echocardiography revealed an enlargement of the aneurysm on the anterior and right of the RA. Its orifice was 11 mm, appendage area was 18 cm2, and diameter of aneurysm was 18 mm (Figure 3). The diagnosis of an RAA aneurysm was confirmed by cardiac CT, which showed a large aneurysm of the right atrial appendage, measuring 18 × 12 mm (Figure 4).

Aspirin was started with antiagregant dose to prevent thromboembolism. The medical treatment of our patient is still going on without any complication in his follow-up.

3. Discussion

Aneurysms are very rare malformations and may be either congenital or acquired [1, 3]. The most infrequent location is in the RAA. Clinical manifestation is in the range from asymptomatic condition to arrhythmia and repetitive pulmonary embolism [4, 5]. Asymptomatic conditions can be diagnosed prenatally or incidentally [1, 6]. Even though the patient may be asymptomatic, it is essential to diagnose atrial appendage aneurysm because of its complications [6].

The diagnosis can be made by noninvasive techniques such as transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). A routine chest radiography can show a dilated right atrium. Magnetic resonance imaging and CT can also confirm the diagnosis [1, 7]. It is possible to diagnose RAA aneurysm prenatally with fetal echocardiography. For some cases in which surgery is not recommended, oral anticoagulant administration is necessary due to thromboembolic risk. Surgical approach can be necessary for progressive enlargement of RAA aneurysm or symptoms [6, 8].

In our case, we have chosen anticoagulant therapy (aspirin 3 mg/kg/day) due to the absence of any complication.

In conclusion, aneurysm of the RAA is a rare malformation, which can cause atrial arrhythmias or embolic phenomena. Without any symptoms, it is important to prevent thromboembolism with the medical therapy in RAA aneurysm which is diagnosed in prenatal period with echocardiography or incidentally in chest radiography.


All authors have read and approved submission of the manuscript.

Competing Interests

There is no conflict of interests regarding this paper.


  1. N. E. Duran, E. Ertük, S. Gündüz, and M. Özkan, “Aneurysm of the right appendage in an eldery patient,” Archives of the Turkish Society of Cardiology, vol. 37, pp. 122–124, 2009. View at: Google Scholar
  2. S. Sevimli, F. Gundogdu, E. Aksakal, S. Arslan, Y. Gurlertop, and H. Senocak, “A rare congenital anomaly: biatrial appendage aneurysm with atrial and ventricular septal defect,” Echocardiography, vol. 24, no. 9, pp. 987–990, 2007. View at: Publisher Site | Google Scholar
  3. S. H. Barberato, M. F. A. Barberato, B. M. Ávila, S. Perretto, L. D. R. G. Blume, and M. Chamma Neto, “Aneurysm of the right atrial appendage,” Arquivos Brasileiros de Cardiologia, vol. 78, no. 2, pp. 236–241, 2002. View at: Publisher Site | Google Scholar
  4. C. J. A. M. Zeebregts, A. G. Hensens, and L. K. Lacquet, “Asymptomatic right atrial aneurysm: fortuitous finding and resection,” European Journal of Cardio-Thoracic Surgery, vol. 11, no. 3, pp. 591–593, 1997. View at: Publisher Site | Google Scholar
  5. P. Staubach, “Large right atrial aneurysm: rare cause of recurrent pulmonary embolism,” Zeitschrift fur Kardiologie, vol. 87, no. 11, pp. 894–899, 1998. View at: Publisher Site | Google Scholar
  6. R. D. Tunks, J. Malysz, and J. B. Clark, “Neonatal management of a Giant Right atrial Appendage aneurysm,” Circulation, vol. 10, article 132, 2015. View at: Google Scholar
  7. N. Yildirim and Z. Gölbaşi, “Echocardiographic diagnosis of a case with giant right atrial aneurysm,” Echocardiography, vol. 23, no. 2, pp. 140–142, 2006. View at: Publisher Site | Google Scholar
  8. R. Chatrath, O. Turek, E. S. Quivers, D. J. Driscoll, W. D. Edwards, and G. K. Danielson, “Asymptomatic giant right atrial aneurysm,” Texas Heart Institute Journal, vol. 28, no. 4, pp. 301–303, 2001. View at: Google Scholar

Copyright © 2016 Helen Bornaun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Related articles

No related content is available yet for this article.
 PDF Download Citation Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

No related content is available yet for this article.

Article of the Year Award: Outstanding research contributions of 2020, as selected by our Chief Editors. Read the winning articles.