CTICasesSevere Left Atrial Wall Thickening (Rheumatic Heart Disease)
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Imaging findings
CT shows a big pulmonary artery and strikingly thickened left atrium. The orifices of the pulmonary veins appear somewhat narrowed. Cardiac MRI confirms significant thickening of the left atrial wall and shows a partial obstruction of the mitral valve with limited anterior leaflet opening during systole, indicating valvular disease. The left ventricle maintains a squeeze, but relaxation appears impaired. No thrombus was found along the septum. No calcification was noted in the atrial wall.
Key takeaways
This case presents a severe example of left atrial wall thickening, in the context of rheumatic heart disease and associated mitral valve dysfunction. This degree of mural thickening can be a precursor to atrial calcification, a known chronic manifestation of rheumatic heart disease. Distinguishing from infiltrating tumors or thrombus is important.
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