Giant Left Atrium Causing Acute Pulmonary Edema: A Case Report

A patient who went through mitral valvuloplasty 11 years ago due to rheumatic heart disease was admitted to our hospital with progressive shortness of breath and lower extremity edema. There was atrial fibrillation in her ECG. Her heart rate was 154 beats/min on average. After the patient was stabilized, we applied imaging methods to find out the cause of the dyspnea. An increased cardiothoracic ratio was detected on an x-ray. The cardiothoracic index was measured as 0.78 on Chest X-ray. Transthoracic echocardiography and computed tomography of the thorax revealed that the cause was the giant left atrium. On the transthoracic echocardiogram performed, ejection fraction was 55%, and it was found that the left atrium was approximately 19.7x11.6 cm in the longitudinal short axis and it was compressing the left ventricle, right ventricle, and right atrium In contrast-enhanced thorax computed tomography, in axial images, the anterior-posterior diameter of the left atrium was found to be 9 cm, the transverse diameter was detected as 19.5 cm, and the longitudinal diameter of the left atrium was measured as 15cm in the measurements made from the middle of the transverse diameter in sagittal images In this case report, we aimed to present a rare case of large left atrium seen by the emergency physician in a patient with pulmonary edema findings with preserved ejection fraction.