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Mechanical discordance between left atrium and left atrial appendage.
Arash Khamooshian1, Jelliffe Jeganthan2, Yannis Amador2
1Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Cardio-Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Annals of Cardiac Anaesthesia
|January 17, 2018
Summary
Even in sinus rhythm (SR), the left atrial appendage (LAA) can show irregular activity. This case highlights the importance of assessing the LAA with Doppler, even when the heart rhythm appears normal.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Electrophysiology
Background:
- Standard transesophageal echocardiography (TEE) in sinus rhythm (SR) patients typically does not include routine Doppler assessment of the left atrial appendage (LAA).
- The left atrium and its appendage are crucial for cardiac function and can harbor arrhythmias even in the presence of a normal sinus rhythm.
Observation:
- A case is presented where irregular activity was detected in the LAA of a patient in SR during a TEE examination.
- This observation underscores a potential gap in standard echocardiographic protocols for SR patients.
Findings:
- The LAA requires specific assessment with Doppler, even in SR, to identify potential hemodynamic abnormalities or arrhythmias.
- Irregular LAA activity in SR can be missed if not specifically evaluated.
Implications:
- Routine Doppler assessment of the LAA in SR patients may improve the detection of subtle cardiac conditions.
- This approach could enhance diagnostic accuracy and patient management in cardiovascular medicine.
- Further investigation into the prevalence and clinical significance of LAA activity in SR is warranted.
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