CTICasesLeft Mainstem Bronchus Compression by Giant Left Atrium
Imaging findings
Chest radiograph and CT show a giant left atrium causing marked elevation of the left mainstem bronchus to an acute angle greater than 90 degrees. The bronchus intermedius is displaced in a curvilinear fashion. The compressed left mainstem bronchus is filled with secretions, leading to recurrent left lung collapse.
Key takeaways
Extreme left atrial enlargement (typically from chronic mitral stenosis or regurgitation) can cause severe mass effect on the adjacent airway. This leads to marked left mainstem bronchus compression and elevation, predisposing the patient to mucus plugging and recurrent atelectasis.
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