Presentation
Fatigue and weight loss. Multi-organ sarcoidosis was confirmed with bone marrow biopsy. Past medical history includes mitral valve replacement for rheumatic mitral stenosis, chronic atrial fibrillation, congestive heart failure, coronary atherosclerosis, and chronic renal disease.
Patient Data
CT images show widespread calcification of the left atrial wall compatible with porcelain left atrium.
Mitral valve replacement and pacemaker.
Case Discussion
Porcelain left atrium, or coconut left atrium is a rare occurrence characterized by massive calcification of the left atrium which leads to hardening and thickening of the atrial wall. This patient had risk factors including mitral valve replacement for rheumatic mitral stenosis and renal failure. This condition is commonly associated with atrial fibrillation, as in this case.
Massive calcification of the left atrium may necessitate endoatriectomy at the time of valve replacement.
The patient's condition was stable and no further treatment was required.
Case courtesy of and co-authored by Dr. Sayf Al-Katib.
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