Left atriomegaly

2D imaging views: upper left: apical 4-chamber; upper right: apical 2-chamber; lower left: apical 3-chamber (long axis); lower right: subcostal 4-chamber. Images courtesy of dr. Fabrizio Celeste.

#tt3662. Extreme left atrial dilatation (atriomegaly) in 83 y.o patient with permanent atrial fibrillation, chronic coronary artery disease, arterial hypertension,  and previous surgical mitral valvuloplasty. NYHA class II.
Left ventricular (LV) biplane end-diastolic volume index= 60 ml/m2; LV ejection fraction= 62 %; moderate mitral regurgitation with no significant restriction to LV inflow (mean diastolic transmitral gradient= 6 mmHg).

End-systolic (maximum) left atrial volume: 4-chamber= 1866 ml; 2-chamber= 1137 ml; biplane (modified Simpson’s rule)= 1426 ml (801 ml/m2).

Planimetry of the left atrium in 4-chamber view

Planimetry of the left atrium in 4-chamber view

Chest X-ray, antero-post

Chest X-ray, antero-post

Chest X-ray, lateral

Chest X-ray, lateral

On chest X-ray, the left atrium spans the entire width of the thorax.

 

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