Giant left atrium with rheumatic mitral stenosis.

Area of Science:

• Cardiology
• Radiology
• Cardiac Surgery

Background:

• Rheumatic mitral stenosis is a significant cause of cardiac disease.
• Giant left atrium can lead to severe cardiac structural distortion.
• Timely surgical intervention is critical for managing mitral stenosis.

Observation:

• A chest radiograph revealed cardiac enlargement in a 38-year-old woman with mitral stenosis.
• The enlargement was attributed to a giant left atrium, measuring 18.7 cm.
• The giant left atrium distorted the patient's cardiac structures, with a cardiothoracic ratio of 0.90.

Findings:

• Echocardiography is effective in delineating giant left atria.
• The patient presented with the largest reported left atrial diameter to date.
• Delayed mitral valve replacement in severe mitral stenosis can be fatal.

Implications:

• This case highlights the extreme anatomical changes possible with rheumatic mitral stenosis.
• Early surgical management is paramount to improve outcomes and prevent mortality.
• Reporting the largest giant left atrium emphasizes the need for vigilant monitoring and timely intervention.