Left atrial enlargement

Case contributed by Rade Kovač


Long-standing dyspnea and intermittent abdominal pain

Patient Data

Age: 60 years
Gender: Male

Huge cardiomegaly due to massively enlarged left atrium with dilated pulmonary veins, and compressive atelectasis of the adjacent lung bilaterally. Other cardiac chambers are compressed and displaced.

IVC and hepatic veins are severely dilated. There is marked periportal edema (periportal halo).

Case Discussion

This case illustrates how much the left atrium can enlarge due to chronically elevated left atrial pressures, elevated left atrial volume, or both. Most common causes include left ventricular dysfunction, mitral valve disease, atrial fibrillation, and arterial hypertension.

Every time the left atrial enlargement is identified on CT, one must look for possible thrombus formation, especially in the left atrial appendage.

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