Rahman M M, Pasha K, Mohsin M K, Marufuzzaman S, Habib S M, Islam M N, Debnath R C
Department of Cardiology, Comilla Medical College, Comilla, Bangladesh.
Mymensingh Med J. 2011 Jan;20(1):155-8.
Isolated left atrial (LA) aneurysm is a rare condition, whereas LA aneurysm secondary to other causes is a fairly common condition. A case of large left atrial aneurysm presented with features of heart failure with cardiac arrhythmia and an abnormal cardiac silhouette on chest X-ray. A 14 years old girl presented with palpitation at rest, shortness of breath, productive cough and bilateral leg swelling for last 8 months. There was no history of chest pain, hemoptysis, syncope, prolonged fever, and rheumatic fever. She was mildly anemic, had raised JVP and mild bilateral pedal edema. There was left parasternal heave, soft S1, loud P2 and a pansystolic murmur of grade 3/6 over mitral area radiating to the left axilla. ECG showed multifocal atrial tachycardia (MAT), chest X-ray showed cardiomegaly with bulging of the left heart border with upper lobe diversion. Echo-Doppler study showed hugely dilated LA (115 mm in diameter), dilated left ventricle, Grade-2+ mitral regurgitation (MR), mild tricuspid regurgitation (TR) and mild pulmonary hypertension with normal appearing mitral, aortic and tricuspid and pulmonary valves. The patient was diagnosed as a case of congenital aneurysm of LA.
孤立性左心房（LA）动脉瘤是一种罕见疾病，而继发于其他原因的LA动脉瘤则较为常见。一例巨大左心房动脉瘤患者表现出心力衰竭、心律失常的症状，胸部X线检查显示心脏轮廓异常。一名14岁女孩在过去8个月中出现静息时心悸、呼吸急促、咳痰和双侧腿部肿胀。无胸痛、咯血、晕厥、长期发热及风湿热病史。她轻度贫血，颈静脉压升高，双侧足部轻度水肿。胸骨左缘有抬举样搏动，第一心音柔和，第二心音亢进，二尖瓣区有3/6级全收缩期杂音，向左腋窝传导。心电图显示多源性房性心动过速（MAT），胸部X线显示心脏增大，左心缘膨隆伴上叶血流转向。超声心动图研究显示LA极度扩张（直径115mm），左心室扩张，二尖瓣反流（MR）2+级，三尖瓣反流（TR）轻度，肺动脉高压轻度，二尖瓣、主动脉瓣、三尖瓣和肺动脉瓣外观正常。该患者被诊断为先天性LA动脉瘤。
