Multimodality imaging including TEE and MRI is effective for diagnosing intrapericardial left atrial aneurysm, which can be successfully treated with surgical removal to resolve atrial fibrillation.
Single-case symptom resolution after resection suggests possible benefit; leaves open standardized diagnostic and management strategies for this rare entity.
A case of intrapericardial left atrial aneurysm is described in a 38-year-old woman, who presented with invalidating paroxysmal atrial fibrillation. The diagnosis was suspected by 2D-echocardiography, and confirmed by transoesophageal echocardiography and magnetic resonance imaging. Chest X-ray, right and left ventricular and coronary angiography were normal. The aneurysm was surgically removed, and the patient has subsequently remained free from symptoms.
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Gullestad et al. (1991) studied this question.
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