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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006880
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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}yahoo.in

Description

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 …

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