Marked bilateral atrial dilation of unknown cause

Area of Science:

• Cardiology
• Geriatric Medicine
• Electrophysiology

Background:

• Elderly patients often present with complex cardiac conditions.
• Atrial dilation and cardiomegaly can be associated with various cardiac abnormalities.
• Understanding the prognosis of cardiac findings in the elderly is crucial for patient management.

Observation:

• Four elderly women presented with marked bilateral atrial dilation.
• All patients exhibited severe cardiomegaly on chest radiographs.
• No significant structural or functional cardiac abnormalities were noted, apart from atrial fibrillation.

Findings:

• Three patients maintained good health for 6 to 16 years.
• Manageable edema and pleural effusion were observed in three patients, treated with diuretics and/or digitalis.
• The fourth patient experienced a single episode of edema and effusion before passing away at age 100 from unrelated causes.

Implications:

• Severe cardiomegaly and atrial dilation in the elderly may not always correlate with poor cardiac outcomes.
• Atrial fibrillation in this context might be well-managed with standard therapies.
• This suggests a potential for favorable long-term prognosis in select elderly patients with these cardiac findings.