A sixty-two-year-old white woman with a 14.5 cm (145 mm) silent giant left atrial enlargement secondary probably to rheumatic heart disease is presented. Aside from mild progressive shortness of breath during the past year, the patient had been asymptomatic all her life. Her clinical picture was manifested for the first time by syncope secondary to slow atrial fibrillation, for which a permanent pacemaker was required. The correct diagnosis of the enlarged chamber was not possible through the routine chest roentgenogram. In this case, the echocardiogram, nuclear angiogram, and computed tomography were the pertinent studies needed to reach the diagnosis.
Get full access to this article
View all access options for this article.
References
1.
Rackley CE, Edwards JE, Karp RB: Mitral valve disease. In: The Heart, ed. 7, ed. by Hurst JW.New York: McGraw-Hill, 1990, pp 820-851.
2.
Bramlet LA, Edwards JE: Congenital aneurysm of left atrial appendage. Br Heart J45:97-100, 1985.
3.
Lipkin D., Colli A., Somerville J.: Aneurysmal dilatation of left atrial appendage diagnosed by cross sectional echocardiography and surgically removed. Br Heart J53:69-71, 1985.
4.
Pinamonti B. , Alberti E., Buttignol G., et al: Echocardiographic diagnosis of congenital left atrail aneurysm. Am Heart J111:406-409, 1986.
5.
Gould LA, Betzu R., Sing Yang DC, et al: Giant left atrium. A case report. Angiology42:52-54, 1991.
6.
Root JD, Hammerman AM, Fischer KC: The CT appearance of the giant left atrium. Clin Imaging14:305-308, 1990.
7.
OK JK: Echocardiographic evaluation of morphological and hemodynamic significance of giant left atrium. An important lesson. Circulation86:214-225, 1992.
8.
Isomura T., Hisatomi K., Hirano A., et al: Left atrial plication and mitral valve replacement for giant left atrium accompanying mitral lesion. J Cardiac Surg8:365-370, 1993.
