Lipomatous Hypertrophy

 

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  • Massive IAS Hypertrophy

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This apical 4 chamber view shows an enlarged interatrial septum consistent with lipomatous hypertrophy. This is a somewhat remarkable case given the large size and it can easily be mistaken for a tumor. This condition has been reportedly seen in anywhere from 1-8% of individuals and increases in incidence with age and body mass.

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Characteristic features include the location around the atrium septum that spares the fossa ovalis. Note here how on either side of the fossa, there is marked thickening, but that the fossa is still thin. In this case the more posterior/superior aspect is quite round and thick. In other cases, there is more symmetry on either side of the fossa, resulting in a dumbbell or hourglass shape.

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Another key feature, as seen here in a subcostal view in addition to the apical views above, is that the thickened tissue is the same density as the surrounding tissue. Confirmation in equivocal cases can be made with cardiac MRI. Frequently this is a benign condition, but it can be associated with arrhythmias on occasion.