DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.001

Pages: 2400-2403

Background: Atrial septal aneurysm (ASA) is a rare cardiac anomaly characterized by a saccular deformity of the interatrial septum, often discovered incidentally. It is commonly associated with a patent foramen ovale (PFO) and has been implicated in cardioembolic events, particularly in cryptogenic strokes. Case presentation: We report the case of a 35-year-old male with no significant medical history, who presented with progressive pain, pallor, and cyanosis of the fingers of his left hand. Vascular imaging revealed complete thrombosis of the radial and ulnar arteries. Cardiac investigations identified an isolated ASA without any PFO or arrhythmia. The patient underwent urgent surgical embolectomy and was initiated on lifelong anticoagulation therapy. Postoperative evolution was favorable, with clinical improvement observed at three-month follow-up. Conclusion: This case highlights an exceptional presentation of ASA, revealing itself through peripheral arterial embolism in the absence of a PFO. It underlines the potential thromboembolic risk associated with isolated ASA and the importance of considering this diagnosis even in unusual ischemic presentations.