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Rare Case of a Giant Left Atrium With Cerebrovascular Accident

Antoine El Khoury1, Marc Achkar2, Samer Nasr2

  • 1Cardiology, University of Balamand, Faculty of Medicine and Medical Sciences, Beirut, LBN.

Cureus
|May 31, 2021
PubMed

Insights

Extremely dilated left atrium is rare but increases stroke risk. Maintaining a slightly elevated international normalized ratio (INR) may reduce ischemic events in these patients.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Left atrium enlargement is common in valvular heart disease and atrial fibrillation.
  • Extremely dilated left atrium is a rare condition with limited literature.
  • Dilated left atrium increases stroke risk due to blood stasis.

Observation:

  • A case of severely dilated left atrium (12.7 cm diameter, 200 cm² area, 2000 cc volume) is presented.
  • The patient had a functioning prosthetic mechanical mitral valve.
  • The patient experienced a cerebrovascular accident despite anticoagulation with warfarin and aspirin.

Findings:

  • The severely dilated left atrium presented a significant risk for ischemic events.
  • Standard anticoagulation therapy did not prevent a cerebrovascular accident in this case.

Implications:

  • Slightly elevated international normalized ratio (INR) may be beneficial for stroke prevention in patients with extremely dilated left atrium.
  • Further research is needed to establish optimal anticoagulation strategies for this rare condition.

Keywords:
atrial fibrillationcerebrovascular accidentenlarged left atriumgiant left atriummechanical valvestroke

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