Symptomatic right atrial appendance aneurysm: diagnosis and resection

Abstract

Idiopathic right atrial enlargement is a rare cardiac anomaly presenting as a giant right atrium. A 20-year-old woman presenting for pneumothorax was found to have a pericardial mass compressing right ventricle. Echocardiography and magnetic resonance suggested the diagnosis of lone right atrial appendance enlargement. The mass was surgically removed and histopathology confirmed the diagnosis of right atrial appendance aneurysm. The case is notable for its rarity.

Right Atrial Appendage Aneurysm: A Systematic Review

“…8 TTE is the first imaging tool for the diagnosis of a RAAA, however, it has a poor sensitivity of 12% in this review. 8 TTE is the first imaging tool for the diagnosis of a RAAA, however, it has a poor sensitivity of 12% in this review.…”

“…Although reported in all age group, the RAAA is most commonly seen in 3rd decade of life. 1) 8,9 Clinical Feature and Diagnosis: Palpitation due to atrial tachyarrhythmias (flutter or fibrillation) is the most common presentation of RAAA. 3,4 It is believed that congenital type is caused by dysplasia of muscular wall of right atrium.…”

“…(Fig. 1) 8,9 Clinical Feature and Diagnosis: Palpitation due to atrial tachyarrhythmias (flutter or fibrillation) is the most common presentation of RAAA. Asymptomatic individuals are diagnosed incidentally during cardiac imaging, autopsy, or cardiac surgery performed for other reasons.…”

Pediatric Giant Right Atrial Aneurysm: A Case Series and Review of the Literature

“…Many cases with atrial tachyarrhythmias have been described with highly variable response to anti‐arrhythmic therapy . Although quite rare, a few published cases of pediatric GRAA have presented with respiratory symptoms including recurrent lower respiratory tract infections and pneumothorax . Only two cases in the literature describe symptomatic airway obstruction .…”

“…4 Although quite rare, a few published cases of pediatric GRAA have presented with respiratory symptoms including recurrent lower respiratory tract infections and pneumothorax. 12,13 Only two cases in the literature describe symptomatic airway obstruction. 4,14 In both cases, airway obstruction was reversed after right atrial aneurysm resection, but the postoperative course was complicated by atrial tachycardia.…”