Giant Left Atrium causing acute congestive heart failure: a case report

Yıl 2022, Cilt: 3 Sayı: 1, 27 - 30, 12.03.2022

Murat Duyan , Serhat Günlü , Ali Sarıdaş , Resmiye Nur Okudan , İbrahim Ulaş Özturan

https://doi.org/10.48176/esmj.2022.52

Öz

A patient who went through mitral valvuloplasty 11 years ago due to rheumatic heart disease was admitted to our hospital with progressive shortness of breath and lower extremity edema. There was atrial fibrillation in her ECG. Her heart rate was 154 beats/min on average. After the patient was stabilized, we applied imaging methods to find out the cause of the dyspnea. An increased cardiothoracic ratio was detected on an x-ray. The cardiothoracic index was measured as 0.78 on Chest X-ray. Transthoracic echocardiography and computed tomography of the thorax revealed that the cause was the giant left atrium. On the transthoracic echocardiogram performed, ejection fraction was 55%, and it was found that the left atrium was approximately 19.7x11.6 cm in the longitudinal short axis and it was compressing the left ventricle, right ventricle, and right atrium
In contrast-enhanced thorax computed tomography, in axial images, the anterior-posterior diameter of the left atrium was found to be 9 cm, the transverse diameter was detected as 19.5 cm, and the longitudinal diameter of the left atrium was measured as 15cm in the measurements made from the middle of the transverse diameter in sagittal images
In this case report, we aimed to present a rare case of large left atrium seen by the emergency physician in a patient with pulmonary edema findings with preserved ejection fraction.

Anahtar Kelimeler

giant left atrium, rheumatic heart disease, heart failure, echocardiography, dispne

Destekleyen Kurum

The authors declare no conflict of interest or any financial support.

Akut konjestif kalp yetmezliğine neden olan dev sol atriyum: bir olgu sunumu

Öz

11 yıl önce romatizmal kalp hastalığı nedeniyle mitral valvüloplasti ameliyatı olan hasta ilerleyici nefes darlığı ve alt ekstremite ödemi ile hastanemize başvurdu. Ekg’sinde atriyal fibrilasyon vardı Kalp hızı ortalama 154vuru/dk idi. Hasta stabil hale getirildikten sonra nefes darlığının nedenini öğrenmek için görüntüleme yöntemlerine başvurduk .Röntgende artmış kardiyotorasik oran tespit edildi. Kardiyotorasik indeks göğüs X-ray’de 0.78 olarak ölçüldü. Transtorasik ekokardiyografi ve toraks bilgisayarlı tomografisi, nedenin dev sol atriyum olduğunu gösterdi. Yapılan transtorasik ekokardiyogramda ejeksiyon fraksiyonu %55 olup, sol atriyumun longitudinal kısa eksende yaklaşık 19.7x11,6 cm boyutlarında olduğu ve sol ventrikül, sağ atriyum ve sağ ventriküle bası yaptığı saptandı. Kontrastlı toraks bilgisayarlı tomografisinde, aksiyel görüntülerde sol atriyum ön-arka çapı 9 cm, enine çapı 19.5 cm sagital görüntülerde transvers çapın ortasından yapılan ölçümlerde sol atriyum çapı 15cm olarak ölçüldü. Bu olgu sunumunda korunmuş ejeksiyon fraksiyonlu pulmoner ödem bulguları olan bir hastada acil hekimi tarafından nadir görülen büyük sol atriyum olgusunu sunmayı amaçladık.

Anahtar Kelimeler

dev sol atriyum, romatizmal kalp hastalığı, kalp yetmezliği, ekokardiyografi, nefes darlığı

Kaynakça

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