BMJ Case Reports 2012; doi:10.1136/bcr-2012-006880
  • Images In…

Giant left atrium with spontaneous echo contrast: a harbinger of thromboembolic phenomenon

  1. Manjunath C Nanjappa
  1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
  1. Correspondence to Dr Bhupinder Singh, dr_bhupinders{at}


A 25-year-old man presented with worsening dyspnoea on exertion of 5 months duration along with two episodes of thromboembolic stroke to the left side of the body over a span of the last 2 months. The patient had a history suggestive of rheumatic heart disease. On cardiac auscultation, a long rumbling mid-diastolic murmur was heard. ECG showed atrial fibrillation. Chest roentgenogram (figure 1A) revealed cardiomegaly with enlarged left atrial appendage (white arrows), splaying of carinal angle (thick black arrows) and double-density sign (black arrows) along the right cardiac border suggesting left atrium (LA; black …

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article