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BMJ Case Reports 2018; doi:10.1136/bcr-2018-224573
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Asymptomatic left atrial appendage aneurysm (LAAA) with pericardial defect in a 1-year-old girl

Open Access
  1. Shigeo Kure1
  1. 1 Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
  2. 2 Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan
  1. Correspondence to Dr Chiharu Ota, chiha-s{at}mbd.ocn.ne.jp
  • Accepted 15 May 2018
  • Published 4 June 2018

Description

A 1-year-old Japanese girl was referred to our hospital with a heart murmur. The patient had no other symptoms indicating cardiovascular or respiratory problems. A chest radiograph revealed a bulging upper-left heart border without cardiomegaly (figure 1A). Further examinations were performed to determine the cause of the heart bulge. Potential causes included enlargement of the pulmonary artery, a mediastinal tumour, a cardiac tumour, a pericardial cyst and left atrial enlargement due to mitral valve disease or atrial aneurysm.

Figure 1

(A) A chest radiograph demonstrating a bulged upper left heart border without cardiomegaly. (B–C) Transthoracic echocardiograms. (B) Parasternal short axis view at the aortic valve level revealing a LAAA without thrombosis. (C) Apical four-chamber view showing the LAAA next to left atrium. LAAA, left atrial appendage aneurysm.

ECG examination showed normal sinus rhythm, but an echocardiogram revealed a left atrial appendage aneurysm (LAAA) without thrombosis (figure 1B and C). Chest CT showed a LAAA (figure 2A, indicated by a white arrow), interposition of the left lung (a white arrowhead) between the LAAA and the left ventricle and …

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