Extreme Left Atrial Enlargement

Abstract

Ten patients with extreme left atrial enlargement are reported, with post mortem findings in 6. In all cases, the left atrium either touched the right chest wall, or extended to within 1 cm of it. The largest left atrium in the series contained 2500 cc. A marked increase in blood volume is characteristic. Systemic embolism and significant pulmonary hypertension were infrequent. In general, the patients survived in surprisingly good health for many years despite the enormous heart size. Etiologically, some of the significant features include mitral insufficiency as the major cardiac lesion with slight to moderate mitral stenosis also present, the onset of atrial fibrillation at an early age and continuing for many years, and except for 1 case, a severe initial attack of rheumatic fever often with frequent recurrences.