A left atrial appendage aneurysm (LAAA) is a rare congenital or acquired anomaly that often causes fatal complications. Although many reports recommend surgical resection for treatment, there is no clear definition of LAAA. Therefore, the diagnosis and treatment are ambiguous. A 73-year-old woman with cardiogenic stroke was admitted to our hospital because of a suspected LAAA as the source of the embolus. She was incidentally diagnosed with LAAA seven years ago, which was managed with continuous anticoagulation therapy, although atrial fibrillation was not observed. The patient underwent aneurysm resection, and the postoperative course was uneventful.As LAAA symptoms are nonspecific, careful observation is required when LAAA is suspected. The risks associated with surgery are generally low and the surgical outcome is good; however, even with appropriate medical therapy, fatal complications can occur. Therefore, surgical resection of the LAAA should be considered even in asymptomatic patients, considering the low surgical risk.
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