CTICasesGiant Left Atrial Aneurysm
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Imaging findings
Chest radiography demonstrates a double density along the right heart border, elevation of the left main bronchus, and posterior displacement of the left lower lobe bronchus. Cardiac MRI reveals a giant, aneurysmal left atrium with a massive jet of mitral regurgitation and slow-flow spontaneous echo contrast (smoke) within the dilated chamber, while other cardiac chambers are normal in size.
Key takeaways
Giant left atrium is a rare condition defined by massive enlargement of the left atrial chamber, often seen as a long-term sequela of mitral valve disease, rheumatic heart disease, or complex congenital heart repairs (such as endocardial cushion defect or tricuspid atresia reconstructions). The massive enlargement can cause significant mechanical compression of adjacent mediastinal structures, such as the airways and esophagus, and carries a high risk of atrial fibrillation, intracardiac thrombus formation, and systemic thromboembolism.
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