2025/07/17 by Gerald Riordan, Jonathan Forsey, G. Gnanappa +2 · 1 voice
Medicine · #Atrial Fibrillation Management and Outcomes #Cardiac Arrhythmias and Treatments #Cardiac Structural Anomalies and Repair
paper · doi:10.1093/ehjci/jeaf207
openalex publication_date 2025/07/17 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
A 12-year-old male presented to his primary care physician with 2-months of persistent cough following a viral illness. Chest X-ray revealed cardiomegaly. He was referred to a tertiary centre with concerns for a pericardial effusion. Transthoracic echocardiography demonstrated a large left atrial appendage aneurysm (LAAA) compressing the left ventricle (Panel B and Supplementary data online, Movie S1). This was confirmed on CT, which also showed mild secondary left lower lobe atelectasis. The LAAA was further illustrated with a 3-dimensional CT reconstruction (Panel A and Supplementary data online, Movie S2). Transoesophageal echocardiography identified no thrombus, and the patient underwent surgical resection with no complications. The LAAA measured 10 × 9.1 × 8.9 cm (Panel C). Post-operative imaging revealed an organized clot within the non-communicating small residual aneurysmal cavity, which was managed conservatively. His respiratory symptoms resolved post-operatively. LAAA is a rare cardiac anomaly that can produce a spectrum of clinical complications including tachyarrhythmias, thromboembolism, and respiratory compromise. Due to its rarity and non-specific symptoms, diagnosis is often delayed. Improved awareness of LAAA is important to reduce diagnostic delay and potentially dangerous sequalae.