CTICasesCongenital Left Atrial Appendage Aneurysm
Imaging findings
Chest radiograph shows a prominent bulge along the left upper cardiac border, and chest CT confirms a massive, aneurysmal dilatation of the left atrial appendage projecting anteriorly and laterally. The cavity contains high-attenuation material with Hounsfield units in the 50s, raising concern for thrombus, in the absence of a pericardial defect.
Key takeaways
Congenital aneurysm of the left atrial appendage is an extremely rare cardiac anomaly that can present as an incidental mediastinal mass on chest radiographs. Because these aneurysms are associated with a high risk of thromboembolic events, tachyarrhythmias, and rupture, patients are typically placed on prophylactic anticoagulation or referred for surgical excision.
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