Left atrial compression by a mediastinal bronchogenic cyst presenting with paroxysmal atrial fibrillation.

Abstract

Mediastinal bronchogenic cysts develop from abnormal budding of the primitive tracheobronchial tree. They are usually located in the mediastinum at the level of the tracheal bifurcation. In adults they are frequently asymptomatic and are discovered incidentally on the chest radiograph. As they enlarge they may cause symptoms referable to tracheal, bronchial, or oesophageal compression.' Extrinsic compression of the heart or great vessels appears to be a very rare occurrence.' 3 Case report A 36 year old man was admitted to the cardiac department because of the sudden onset of palpitation and dizziness. His previous clinical history was unremarkable. On admission the electrocardiogram showed atrial fibrillation with a rapid ventricular response of 170 beats/min and a pattern of incomplete right bundle branch block. The patient was

Esophageal achalasia compressing left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome

“…h e a r t & l u n g 4 1 ( 2 0 1 2 ) e 3 1 ee 3 4 aortic aneurysm and dissection, and diaphragmatic and hiatal hernia. [1][2][3] The LA compression by upper gastrointestinal structures, such as the stomach or esophagus, is uncommon 1-3 (Table 1). Achalasia is an idiopathic motility disorder characterized by impaired relaxation of the lower esophageal sphincter and loss of peristalsis in the distal two thirds of the esophagus.…”

“…[1][2][3] Clinical presentations may mimic that seen with more common clinical catastrophes, such as pulmonary embolus, acute myocardial infarction, or acute respiratory failure. [1][2][3] The possible mechanisms for the decreased cardiac output and pulmonary congestion include obstruction of the LA inflow and direct impairment of ventricular filling, thereby causing functional tamponade. 1-3 TTE is the test of choice for diagnosing the LA compression 7-10 ( Table 1).…”

“…We report a rare case of esophageal achalasia compressing the left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome Extrinsic compression of the left atrium (LA) is an uncommon but important cause of hemodynamic compromise that can be caused by gastrointestinal structures (stomach, esophagus, or both) and many mediastinal structures, including bronchogenic cysts, carcinoma, lymphoma, and diaphragmatic hernia. [1][2][3] Achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two thirds of the esophagus. [4][5][6] Contrast echocardiographic imaging after oral ingestion of liquid containing carbon dioxide allowed for differentiation between a compressive vascular structure and the esophagus.…”

Paroxysmal Atrial Fibrillation due to Bronchogenic Cyst

“…There were 11 case reports of bronchogenic cyst and arrhythmia (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In most reports bronchogenic cyst caused tachyarrhythmia, perhaps the potential mechanisms were cyst compression and irritation to the heart mechanically.…”

A 37-year-old man with recurrent fainting: a short communication

“…Anterior masses tend to compress the right heart chambers, whereas posterior ones (hiatal hernia, oesophageal carcinoma) the left atrium and ventricle. 12 Left atrium can be compressed by a bronchogenic cyst, 13 lymphoma. 14 The heart haemodynamics can be affected by the pressure on the superior vena cava from a thymoma, simulating constrictive pericarditis physiology.…”