Incremental benefit of three‐dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

Abstract

Left atrial appendage aneurysm (LAA AN) is a rare disease entity, which can be congenital or acquired in nature. We report an adult patient with LAA AN presenting with anginal chest pain in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over the two-dimensional (2D) technique in providing a more comprehensive assessment of the lesion. A literature review of the salient features of LAA AN is also provided in a tabular form.

Case Report: Giant Congenital Left Atrial Appendage Aneurysm Presenting With Acute Massive Cerebral Infarction and Refractory Atrial Fibrillation: A Case Report and Literature Review

“…Interestingly, during the AF episode, the ST-segment elevation in the precordial leads was recorded. As previously reported, it was likely caused by embolic occlusion of a coronary artery ( 11 ) or by external compression of the coronary arteries by LAAA ( 20 , 25 , 26 ). In our case, the compression of the left coronary artery or its divisions was more likely since no elevation of serial myocardial injury biomarkers was recorded.…”

Left atrial appendage aneurysm in newborns: a report of two cases

“…Acquired left atrial appendage aneurysm develops secondary to left atrial pressure increase due to mitral valve disease or left atrial wall weakening related to tuberculosis or syphilitic myocarditis. 4 Symptoms associated with left atrial appendage aneurysm usually appear during the second to fourth decades of life. The most common symptoms are palpitations and/ or dyspnoea.…”

Prenatally diagnosed left atrial appendage aneurysm with various postnatal imaging investigations: A case report

“…8 Furthermore, since LAAA size increases over several years, it can sometimes manifest clinically in young patients including fetuses. 4,5,9,10 Thus, elective surgery was selected at 7 months of age to reduce the risk of neurological damage as much as possible. Further research is needed to clarify the optimal timing of surgery in asymptomatic pediatric patients with LAAAs.…”

“…It has been reported that open heart surgery with cardiopulmonary bypass in the neonatal period might involve a risk of neurodevelopmental delay 8 . Furthermore, since LAAA size increases over several years, it can sometimes manifest clinically in young patients including fetuses 4,5,9,10 . Thus, elective surgery was selected at 7 months of age to reduce the risk of neurological damage as much as possible.…”