El Khoury Antoine, Achkar Marc, Nasr Samer
Cardiology, University of Balamand, Faculty of Medicine and Medical Sciences, Beirut, LBN.
Cardiology, Mount Lebanon Hospital, Beirut, LBN.
Cureus. 2021 Apr 26;13(4):e14698. doi: 10.7759/cureus.14698.
Left atrium enlargement is very common in patients with valvular heart disease and atrial fibrillation but an extremely dilated left atrium is a very rare condition and rarely reported in the literature. It is a risk factor for ischemic cerebrovascular accidents due to blood stasis as the cavity diameter increases. We are reporting a case of rarely seen severely dilated left atrium with a normal functioning prosthetic mechanical mitral valve with a cerebrovascular accident on anti-vitamin K and aspirin. The patient had a left atrium diameter of 12.7 cm, an area of 200 cm square, and a volume of 2000 cc. We elected to keep the international normalized ratio (INR) slightly above the therapeutic range in order to decrease the risk of ischemic events. It might be necessary to do the same for patients with a similar condition to decrease the stroke rates.
左心房扩大在瓣膜性心脏病和心房颤动患者中非常常见，但极度扩张的左心房是一种非常罕见的情况，在文献中很少报道。随着腔径增加，由于血液淤滞，它是缺血性脑血管意外的一个危险因素。我们报告一例罕见的严重扩张的左心房病例，患者人工机械二尖瓣功能正常，在服用抗维生素K和阿司匹林时发生了脑血管意外。该患者左心房直径为12.7厘米，面积为200平方厘米，容积为2000立方厘米。我们选择将国际标准化比值（INR）略高于治疗范围，以降低缺血事件的风险。对于患有类似情况的患者，可能有必要采取同样的措施以降低中风发生率。
