Prevalence of atrial septal aneurysm in patients with migraine: An echocardiographic study

Objective.-To evaluate the prevalence of atrial septal aneurysm in patients with migraine. Background.-Migraine has long been considered a risk factor for stroke. Atrial septal aneurysm is often observed in young patients with ischemic stroke and is frequently associated with other conditions potentially leading to embolism. Methods.-We performed a transthoracic echocardiogram in 90 consecutive patients (65 women and 25 men; mean age, 35.3 years [standard deviation, 9]) with migraine but free from cerebral and cardiovascular disease and in 53 control subjects (37 women and 16 men; mean age, 34 years [standard deviation, 10]). The diagnosis of atrial septal aneurysm was performed according to Olivares-Reyes criteria. A transesophageal echocardiogram also was performed in 75 patients with migraine (83.3%). Results.-The prevalence of isolated atrial septal aneurysm was higher in patients with migraine with aura (28.5%) than in patients with migraine without aura (3.6%) (P<.005) or in control subjects (1.9%) (P<.005). Conclusions.-Our data suggest a role of atrial septal aneurysm in the genesis of aura in patients with migraine.