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Netherlands Heart Journal

, Volume 25, Issue 9, pp 526–527 | Cite as

Left atrial appendage aneurysm presenting with chronic cough

  • M. Toufan
  • L. Pourafkari
  • A. Afrasiabi
  • M. Sohrabi
  • N. D. NaderEmail author
Open Access
Heart Beat
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A 32-year-old female presented with a 6-month history of worsening non-productive chronic cough and palpitations on moderate exercise. Chest X‑ray showed an increased cardiothoracic ratio with a prominent left heart border. She underwent transthoracic echocardiography in which a large cystic structure with compressive effect on the left ventricle was identified (Fig. 1a). Further evaluation by transoesophageal echocardiography proved the structure to be a large left atrial appendage aneurysm (LAAA) (7.7 × 4.4 cm) with a 1 cm entrance to the atrial cavity (Fig. 1b). The patient underwent aneurysm resection under cardiopulmonary bypass. Fig. 1c shows the resected aneurysm, which had a very thin wall. The postoperative course was uneventful.
Fig. 1

a Transthoracic four chamber echocardiogram showing the aneurysmal left atrial appendage with compressive effect on left ventricle, b Transoesophageal echocardiogram obtained at mid-oesophageal level in 60° showing the left atrial appendage aneurysm, c Intraoperative image showing the resected left atrial appendage aneurysm, LA left atrium, LAA left atrial appendage, LV left ventricle, RA right atrium, RV right ventricle

LAAA are rarely encountered and generally present with palpitations, chest pain, dyspnoea or thromboembolic events [1]. The chronic cough could have been caused by the mechanical airway compression by LAAA. Once diagnosed, surgery is warranted regardless of presence of symptoms.

Notes

Conflict of interest

M. Toufan, L. Pourafkari, A. Afrasiabi, M. Sohrabi and N.D. Nader declare that they have no competing interests.

Supplementary material

Apical four-chamber trans-thoracic echocardiogram showing the large cystic structure that is compressing on the left ventricle

Modified three-chamber transthoracic echocardiogram showing the distortion of the left ventricle contour by the cystic structure

Transoesophageal echocardiogram at 60 degrees midoesophageal level showing the left atrial appendage aneurysm

Transoesophageal echocardiogram at 60 degrees midoesophageal level showing the blood flow in the left atrial appendage aneurysm

References

  1. 1.
    Aryal MR, Hakim FA, Ghimire S, et al. Left atrial appendage aneurysm: a systematic review of 82 cases. Echocardiography. 2014;31:1312–8.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2017

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  • M. Toufan
    • 1
  • L. Pourafkari
    • 1
    • 2
  • A. Afrasiabi
    • 1
  • M. Sohrabi
    • 1
  • N. D. Nader
    • 2
    Email author
  1. 1.Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
  2. 2.Department of AnesthesiologyUniversity at BuffaloNew YorkUSA

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