Porcelain left atrium

Last revised by Liz Silverstone on 17 Jul 2023

Porcelain left atrium, also known as coconut left atrium, is a term used when a large part of or the entire left atrial wall becomes calcified. It can occur as a rare consequence of endocarditis (with underlying rheumatic heart disease). It has also been described in the setting of end-stage renal disease 5.

Some publications use the terms "porcelain left atrium" and "coconut left atrium" as synonymous while others use the term "coconut left atrium" when it involves the interatrial septum 14.

There is a slightly greater female predilection.

Some patients may present with longstanding symptoms although others may be asymptomatic. A concurrent presence of atrial fibrillation and a past history of mitral valve surgery is common.

Calcification of large parts of the left atrial pericardium may suggest the diagnosis.

It may require an endoatriectomy at the time of valve replacement 2.

It was initially described by H Claude and P Levaditi in 1898 8

If it involves only the posterior free wall consider:

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Cases and figures

  • Porcelain left atrium
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