Left Atrial Appendage Aneurysm-A Rare Anomaly with an Atypical Presentation

Abstract

Left atrial appendage aneurysm (LAAA) is a rare condition caused by congenital dysplasia of the atrial muscles. Patients usually present with atrial tachyarrhythmias as a result of ectopic foci of atrial rhythm generation or systemic thromboembolism. We report a case of a 38-year-old Native American female presenting with 1-month history of cough, in sinus rhythm, and found to have a large cyst-like structure next to the left ventricular lateral wall on transthoracic echocardiography. This structure was later confirmed as a LAAA on cardiac magnetic resonance imaging. Patient underwent aneurysmectomy without any complications.

Left Atrial Appendage Aneurysm: A Systematic Review of 82 Cases

“…19,20 However, this distinction can only be made during surgery or at autopsy. 6,38,[40][41][42] There is no clear association of these physical findings to LAAA itself, and are likely a manifestation of the underlying cardiovascular disease. Congenital form arises from dysplasia of musculi pectinati and related atrial muscle bands.…”

“…35 The physical examination may be normal or be significant for tachycardia, 36 irregularly irregular pulse, systolic murmur, 17,37-39 and signs of systemic thromboembolism. 6,38,[40][41][42] There is no clear association of these physical findings to LAAA itself, and are likely a manifestation of the underlying cardiovascular disease. The usual findings on chest x-ray are cardiomegaly with a prominent upper left heart border.…”

Successful radiofrequency ablation of accessory pathway associated with left atrial appendage aneurysm in a low birthweight premature patient

“…2 Left atrial appendage aneurysm (LAAA) is a rare structural anomaly associated with congenital dysplasia of pectinate muscles. 5 Very rarely, mitral valve acquired inflammation and degenerative deformation may be the cause. Histologic studies have shown that aneurysms include three heart layers but myocardium is very thin and fibrotic.…”

Asymptomatic left atrial appendage aneurysm (LAAA) with pericardial defect in a 1-year-old girl

“… 2 Surgical resection is the main treatment option for a LAAA based on the reported cases, regardless of whether the patient is symptomatic, 1 and pericardial defects are usually diagnosed during the surgery. 3 However, in some cases, choosing the optimal timing for the surgery can be difficult if the patient has a small LAAA with no symptoms. In this case, we diagnosed a LAAA with a pericardial defect before surgery and followed the patient for 5 years to lower the risk of intracardiac surgery associated with the patient’s young age.…”