Acta Scientific Clinical Case Reports

Case ReportVolume 3 Issue 8

Dysphagia After Left Atrial Enlargement: A Rare Case Report

Salehabadi Ghazaleh1, Hajahamdi Marjan2 and Shamsedini Ali3*

1Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2Cardiologist, Fellowship in Heart Failure and Transplantation, Department of Cardiology, Hazrat Rasoul Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
3Cardiologist, Department of Cardiology, Rasoul-e-Akram Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

*Corresponding Author: Shamsedini Ali, Cardiologist, Department of Cardiology, Rasoul-e-Akram Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Received: June 29, 2022; Published: July 18, 2022

Abstract

Introduction: Dysphagia after Left Atrial Enlargement (LAE) is rare and usually occurs because of extensive enlargement of left atrium called Giant left atria (3). In this article, a rare case of dysphagia caused by relatively slight LAE is presented.

Case Presentation: 58-year-old female, with no history of serious disease, who presented with dysphagia to solids and postprandial heartburn. Electrocardiography (ECG) was performed prior to further work up regarding the history of exertional dyspnea and atypical chest pain after food intake. The patient's resting 12-lead ECG showed an AF rhythm. Transthoracic echocardiography (TTE) was performed to find out the cause of the AF rhythm. LAE were found in TTE while the size of the other heart chambers was almost normal. Also, severe rheumatismal mitral stenosis and dome shaped MVLs were observed. Trans Thoracic Echocardiography (TTE) was performed to find out the cause of the AF rhythm. LAE were found in TTE while the size of the other heart chambers was almost normal . In EUS view mild external pressure effect from vascular organs and left atrium to mid part was seen. Also, the results of TEE confirmed the evidence of TTE and showed that there is a large left atrial appendage thrombus in left atrium while almost completely have filled it. The diameter of left atrium was calculated 5.7 cm. The patient underwent mitral valve replacement surgery and Tricuspid valve repair and was discharged after a week with a good general condition

Conclusion: Although LAE due to mitral stenosis may be asymptomatic or have not a prominent symptom, however, dysphagia following LAE is a rare condition that may delay the diagnosis and mislead the physicians. In these cases, accurate history taking and clinical examination are critical for proper approach and ECG, CXR and echocardiography help to diagnose after clinical suspicion.

Keywords: Dysphagia; Left Atrial Enlargement; Giant Left Atria

Bibliography

  1. Su G., et al. “Left atrial enlargement in the early stage of hypertensive heart disease: a common but ignored condition”. Journal of Clinical Hypertension (Greenwich),3 (2014): 192-197.
  2. Chick J F., et al. “Giant left atrium in rheumatic heart disease: the classic signs of left atrial enlargement”. Journal of Emergency Medicine6 (20134): e393-394.
  3. Chesshyre MH and Braimbridge M V. “Dysphagia due to left atrial enlargment after mitral Starr valve replacement”. British Heart Journal5 (1971): 799-802.
  4. Chilukuri P., et al. “Dysphagia”. MoMed3 (2018): 206-210.
  5. Rao S C., et al. “Extra-thoracic Extrinsic Compression: An Unusual Cause of Dysphagia”. Endocrine, Metabolic and Immune Disorders - Drug Targets 2 (2019): 230-231.
  6. Gajanana D., et al. “Giant Left Atrium Causing Dysphagia”. Texas Heart Institute Journal5 (2016): 469-471.
  7. Kress S., et al. “Dysphagia secondary to left atrial dilatation”. Z Gastroenterology11 (1997): 1007-1011.
  8. Mishima H., et al. “Dysphagia caused by a left atrial myxoma”. The Journal of Thoracic and Cardiovascular Surgery 4 (2014): 1417-1418.
  9. Digaetano A., et al. “Contribution of bidimensional echocardiography to the diagnosis of left atrial enlargement”. Giornale Italiano di Cardiologia5 (1982): 334-340.

Citation: Shamsedini Ali., et al. “Dysphagia After Left Atrial Enlargement: A Rare Case Report". Acta Scientific Clinical Case Reports 3.8 (2022): 30-33.

Copyright: © 2022 Shamsedini Ali., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.