Giant Left Atrium as a Rare Cause of Dysphagia

Umanzor, Eduardo Josué Flores; Mimbrero, M; Antonio, Rodolfo San; Caldentey, Guillem; Vannini, Luca

doi:10.1016/j.amjmed.2016.05.046

Cited by 1 publication

(1 citation statement)

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“…Partial resection of the inferior and/or superior LA wall at the time of surgery for the mitral valve is a common method for treatment of the giant LA. [7,8] This surgery achieved significant reduction in the LA volume, but is not strongly recommended for patients with poor cardiac function, like our patient, because of the high operative mortality of 8% to 23% caused by low-cardiac-output syndrome and respiratory failure. [8] Furthermore, it was difficult to control end-stage chronic heart failure with partial resection and medication.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of drug-induced esophageal ulcer in a patient with chronic heart failure

Maesaka¹,

Tsujii²,

Shinzaki³

et al. 2018

Medicine

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Rationale:Although esophageal compression due to cardiomegaly may be a risk factor of drug-induced esophageal injuries (DIEIs), the causal relationship between the two conditions has not been fully demonstrated.Patient concerns:We present a case of a drug-induced esophageal ulcer caused by left atrial enlargement in a 44-year-old woman with end-stage hypertrophic cardiomyopathy. Upper gastrointestinal endoscopy showed a deep, circumferential ulcer in the middle thoracic esophagus. CT revealed that the esophagus was compressed between the enlarged left atrium (LA) and the vertebral body. In the upper gastrointestinal series, retention of contrast media was observed in the esophagus near the LA.Diagnosis:The ulcer was a result of potassium chloride retention in the esophagus, which was compressed by the enlarged LA.Intervention:After cessation of potassium chloride administration for 2 months, the ulcer healed and a stricture developed. Two years after the ulcer development, the patient underwent heart transplantation, and subsequent endoscopic balloon dilation was performed for the esophageal stricture.Outcomes:The patient's oral intake recovered completely without any ulcer recurrence.Lessons:The case demonstrated that esophageal compression by the enlarged LA caused a drug-induced esophageal ulcer. Preventive care and treatment measures for DIEIs, including an anatomical approach, should be considered for patients with LA enlargement.

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Section: Discussionmentioning

confidence: 99%