SILENT GIANT LEFT ATRIUM

TOPIC: Cardiovascular Disease TYPE: Global Case Reports INTRODUCTION: Enlarged LA is a common finding in severe mitral stenosis(MS) and regurgitation(MR). It can enlarge to giant proportions. The unusual thirty-year-old woman presenting with only mild dyspnea despite hugely dilated prompted us report this case CASE PRESENTATION: A presented the outdoor clinic complaint of on exertion NYHA class I. Aside from shortness breath during past year, she had been asymptomatic all her life. admission electrocardiogram showed atrial flutter variable block while chest roentgenogram marked cardiac enlargement. right heart border double contour shadow (Fig.2). An echocardiogram left atrium measuring 14.4 X 16.7 cm that encroached other chambers (Fig.3). Thickened valves along doming restricted motion anterior posterior leaflets were diagnostic rheumatic disease(RHD) was surprising find relatively patient distortion anatomy. DISCUSSION: Giant occurs due many reasons but most commonly its result long-standing valve regurgitation or mixed disease predominant regurgitation. Two factors implicated development are increased pressure weakening wall by Rheumatic Pancarditis. When persists for long, it leads enlargement as compensatory mechanism ease markedly which could lead pulmonary Congestion backpressure hemodynamic hence protect hypertension. These mechanisms help patients survive asymptomatically long time. various complications including thromboembolism, edema, hypertension compress esophagus airway causing Dysphagia. CONCLUSIONS: Progressive might be undetected well-tolerated time, even when reaches massive enlarges gigantic size, x-ray insufficient delineate cause cardiomegaly misleading. echocardiographic study useful method evaluating these patients. Our because distorted structures. This led striking x-ray, confused interpreting enlarged silhouette. very helpful demonstrating MS LA. There poor correlation between size severity MS. REFERENCE #1: Kawazoe K, Beppu S, Takahara Y, Nakajima N, Tanaka Ichinashi Fujita T, Manabe H: Surgical treatment combined valvular disease. Plication procedure reduction compression ventricle, bronchus, parenchyma. J Thorac Cardiovasc Surg 1983, 85: 885-892. #2: Hurst W: Memories atrium. Circulation2001, 104: 2630-2631. 10.1161/hc4701.100775 #3: Plaschkes J, Broman JB, Mercin G, Milwidsky disease: of18 cases treated replacement. Ann 1971, 174: 194-201. 10.1097/00000658-197108000-00004 DISCLOSURES: No relevant relationships Vikash Jaiswal, source=Web Response no disclosure submitted Akshyaya Pradhan; Prachi Sharma, Shweta Vohra,