The Shadow Within: A Colossal Left Atrium
Mithun J. Varghese, Tajammul Hussain, Paul V. George, Purendra K. Pati and Jacob V. Jose
Article first published online: 5 DEC 2013 | DOI: 10.1111/echo.12459
A 32-year-old male with rheumatic heart disease presented with atrial fibrillation and severe mitral regurgitation. His chest radiograph showed cardiomegaly and the distinctive shadow within shadow appearance of a distended left atrium (LA); echocardiogram revealed an LA dimension of 15.2 × 12.8 cm and cardiac magnetic resonance imaging disclosed a calculated LA volume of 1950 mL, representing one of the largest reported LA sizes in the current literature.