Park Jong Seon, Lee Dong Hyup, Han Seung Se, Kim Mi Jin, Shin Dong Gu, Kim Young Jo, Shim Bong Sup
Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
J Korean Med Sci. 2003 Apr;18(2):262-6. doi: 10.3346/jkms.2003.18.2.262.
A left atrial aneurysm is a very rare cardiac anomaly that usually develops in the left atrial appendage. It usually develops congenitally, and has a risk of life-threatening complications. Here, we report a case of a growing aneurysm of the left atrium that was incidentally found in a 42-yr-old woman. Eighteen years prior, an abnormal cardiomegaly was found on a chest radiography for a pre-operative study. The chest radiography at this time demonstrated a more prominent cardiomegaly than the previous radiography findings. The left atrial aneurysm was diagnosed by echocardiography and cardiac catheterization. Although asymptomatic, she underwent a successful surgical excision to allay the possibilities of rupture, arrhythmia, heart failure, or thromboembolism. The surgical findings demonstrated an 8 x 15 cm sized saccular aneurysm at the left atrial appendage, and the pathologic findings showed three myocardial layers. The patient has been asymptomatic during the 15 months of follow-up. In conclusion, a congenital left atrial aneurysm can grow with time, even in asymptomatic cases, and an aneurysmectomy is a curative treatment, which can eliminate the potential complications.
左心房动脉瘤是一种非常罕见的心脏异常,通常发生于左心耳。它通常为先天性发育,存在危及生命的并发症风险。在此,我们报告一例42岁女性偶然发现的左心房不断增大的动脉瘤病例。18年前,术前胸部X线检查发现心脏增大异常。此次胸部X线检查显示心脏增大比之前的X线检查结果更明显。通过超声心动图和心导管检查诊断为左心房动脉瘤。尽管无症状,但她接受了成功的手术切除,以降低破裂、心律失常、心力衰竭或血栓栓塞的可能性。手术所见显示左心耳有一个8×15厘米大小的囊状动脉瘤,病理所见显示有三层心肌。在15个月的随访期间,患者一直无症状。总之,先天性左心房动脉瘤可随时间增长,即使在无症状病例中也是如此,动脉瘤切除术是一种根治性治疗方法,可消除潜在并发症。