Giant Left Atrium as a Rare Cause of Dysphagia

University Heart Journal, 2017

Isolated mitral regurgitation is a relatively uncommon presentation of chronic rheumatic heart disease 1 . Chronic nature of rheumatic mitral regurgitation causes gradual dilatation of the left atrium with little increase in pressure and therefore relatively fewer symptoms. However, occasionally the dilatation of LA is so severe, it is termed giant LA. Giant left atrium is a rare condition, with a reported incidence of 0.3%, and occurs following mainly rheumatic mitral valve disease 2 . Atrial fibrillation is almost always present 3 predisposing to thromboembolic complications. A subset of patients may develop severe dysphagia from esophageal compression or hoarseness from laryngeal nerve impingement 4 . Here we are presenting a case of isolated mitral regurgitation with giant left atrium in sinus rhythm. A 30-year-old woman normotensive, non-diabetic presented with the complain of SOB and palpitation for 2 ½ months and leg swelling for 10 days. 2 ½ months back, after 10 days of delivery of her 3 rd child, she developed SOB which was initially present on exertion (NYHA-II) and relieved by rest, but since last 10 days, it was present on minimal exertion or rest (NYHA III-IV) with orthopnea but no PND. She also had dry cough but no hemoptysis or diurnal and seasonal variation. She also had palpitation which occurred with SOB during exertion and was relieved by rest. It was regular and not associated with dizziness or syncope. Since last 10 days, she also developed swelling of legs which was gradually increasing, associated with decreased urine output but no puffiness of face or abdominal swelling. She didn't have history of chest pain,

CASE, 2018

Ecocardiografic nu rareori sunt prezente modific\ri la nivelul atriului drept, date de persisten]a unor structuri embriologice care nu s-au resorbit. Diagnosticul [i conduita terapeutic\ ulterioar\ pentru ace[ti pacien]i este greu de stabilit. O astfel de structur\ este valva lui Eustachio, descris\ frecvent [i care uneori se înso]e[te de complica]ii nea[teptate. Raport\m cazul unei paciente cu o mas\ voluminoasã intraatrial\ dreapt\, la care, la ecocardiografia transesofagian\ sa ridicat suspiciunea de tromb, dar f\r\ a se exclude cu certitudine o structur\ embrionar\. Pacienta a prezentat asociat regurgitare aortic\ degenerativ\ semnificativ\, motiv pentru care s-a intervenit chirurgical. Evaluarea intraoperatorie a atriului stâng a ar\tat o valv\ lui Eustachio mare, forma]iunea a fost excizat\, iar examenul anatomopatologic ulterior a confirmat diagnosticul. De[i prezen]a valvei lui Eustachio este considerat\ a fi o situa]ie rar\, ea nu trebuie omis\ din diagnosticul diferen]ial al pacientului cu mas\ intra-atrial\ dreapt\. Cuvinte cheie: valva lui Eustachio, ecocardiografie, mas\ atrial\ dreapt\.

Case Reports in Cardiology, 2011

Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. In sub-saharan Africa, rheumatic fever is still the leading cause of valvular heart disease. We report a case of an unusual giant right atrium in context of rheumatic stenosis and severe tricuspid regurgitation in a 58-year-old woman.

Arquivos Brasileiros de Cardiologia, 2018

CASE, 2020

IP innovative publication pvt. ltd, 2019

Dysphagia due to compression of esophagus by enlarged left atrium (LA) due to mitral valve pathology is known. However, a functional mitral regurgitation (MR) as a consequence of aortic stenosis (AS) causing LA enlargement and dysphagia is rare and probably not reported. We present a case in which dysphagia was caused by functional MR secondary to AS. Dysphagia resolved significantly after isolated aortic valve replacement within postoperative hospitalization period and completely with improvement in diastolic function as evidenced by follow up echocardiographic examinations. Intraoperative transesophageal echocardiography was also used without any complication despite the patient having dysphagia after conducting preliminary endoscopic examination.

Anesthesia & Analgesia, 2014

2021

Background: The predominant cause of giant left atrium (GLA) is rheumatic mitral valvular disease. GLA is commonly defined echocardiographically by measuring the left atrial diameter (LAD). In the context of changing epidemiology of rheumatic heart disease (RHD) globally, and introduction of left atrial volume index (LAVI), the aetiology of GLA and utility of LAVI for defining GLA may be necessary. Methods: The prospective observational study was carried out at a dedicated tertiary care cardiac centre of a developing country to know the aetiology and clinical pattern of GLA over 8 years. GLA was defined echocardiographically as a left atrium (LA) having a diameter ≥80 mm in the left parasternal long-axis view. Follow-up was made over the telephone. Results: Thirty cases of GLA were diagnosed over 8 years from 2013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7 due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was 92.13 ± 16.72 mm, and the mean LAVI w...

American Heart Journal, 1994