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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.
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 …
Footnotes
Contributors CO and MK (Kimura) performed conception and design, acquisition of data and drafted the article. MK (Kitami) analysed the radiographic data. SK revised it critically for important intellectual content.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textcheck.com/certificate/YXOdHq