Author + information
- Received March 22, 2012
- Revision received April 9, 2012
- Accepted April 24, 2012
- Published online November 6, 2012.
- Aniket Puri, MD, DM⁎,
- Sudarshan Kumar Vijay, MD⁎,
- Gaurav Chaudhary, MD⁎,
- Varun Shankar Narain, MD, DM⁎,
- Rishi Sethi, MD, DM⁎ and
- Pallavi Aga, MD†
A 40-year-old male with history of rheumatic heart disease presented to us with symptoms of dysphagia, hoarseness of voice, and exertional dyspnea. He had past history of closed mitral valvotomy for severe mitral stenosis and open mitral valvotomy later on for restenosis. His electrocardiogram showed the presence of atrial fibrillation (A). The chest roentgenogram posteroanterior view (B) revealed a massive cardiomegaly (cardiothoracic ratio: 0.95). Two-dimensional transthoracic echocardiogram revealed grossly dilated left atrium (LA) (C, Online Video 1) and left atrial appendage with severe mitral regurgitation (D, Online Video 2) and severe mitral stenosis. Multidetector computed tomography angiogram showed a giant left atrium (21.5 × 21 cm) occupying most of the mediastinal space with compression of the adjacent structures (E, F). Three-dimensional volume rendered computed tomography image showed an unusual balloon-like massive dilatation of the left atrium (G).
Giant left atrium is usually described in association with rheumatic heart disease. To the best of our knowledge, this is the largest left atrial size ever reported in the medical literature. DA = descending aorta; LV = left ventricle; RA = right atrium; RPA = right pulmonary artery; RV = right ventricle.
- Received March 22, 2012.
- Revision received April 9, 2012.
- Accepted April 24, 2012.
- American College of Cardiology Foundation