When the left atrium becomes a monster: a case report.

Area of Science:

• Cardiology
• Congenital heart disease

Background:

• Congenital left atrial (LA) aneurysms are exceptionally rare cardiac anomalies.
• They most commonly affect the atrial appendage, with rare occurrences originating from the LA body.

Observation:

• A 31-year-old male with a history of dextrocardia, rheumatic heart disease, and atrial fibrillation presented with heart failure and cardiogenic shock.
• Echocardiography revealed dextro-posed heart due to a giant LA aneurysm, mitral regurgitation, and pulmonary hypertension.
• Computed tomography confirmed the diagnosis and showed compression of the pulmonary arteries by the enlarged LA.

Findings:

• The case highlights a giant LA aneurysm presenting late with significant cardiac compression.
• Diagnostic imaging, including echocardiography and CT, effectively identified the anomaly and its impact.

Implications:

• Congenital LA aneurysms, though rare, are associated with considerable morbidity and can cause arrhythmias or embolic events.
• Prompt diagnosis via non-invasive imaging and surgical resection for symptomatic or large aneurysms are recommended.