Rare case of heart failure caused by compression of the left atrium by a thoracic aortic aneurysm

Thoracoabdominal aneurysm causing functional mitral valve stenosis after total arch replacement

Large thoracic and thoraco-abdominal aneurysms may compress adjacent mediastinal structures. We present a case of a large thoraco-abdominal aneurysm compressing the left atrium and leading to functional mitral valve stenosis after total aortic arch repair, requiring urgent open thoraco-abdominal aneurysm repair.

Compression of the Left Atrium and Left Ventricle by a Thoracoabdominal Aortic Aneurysm: A Case Report

We describe the case of a 66-year-old man with a thoracoabdominal aortic aneurysm, who presented with cardiac failure; he had complained of shortness of breath. A contrast-enhanced computed tomography scan and transthoracic echocardiography showed compression of the left atrium and ventricle by a giant thoracoabdominal aortic aneurysm. The cardiac failure resolved after early prosthetic graft replacement surgery.

Compression of the Left Atrium and Pulmonary Veins Due to Ascending and Descending Aortic Aneurysms

An 89-year-old female patient presented to our cardiology outpatient clinic complaining of shortness of breath and back pain. Chest X-ray demonstrated a widened mediastinum. Transthoracic echocardiography showed an ascending aortic aneurysm and the modified apical 5-chamber view showed that left atrium was compressed between the ascending and descending aortas. Color Doppler turbulence was also seen in the compressed area. A contrast-enhanced chest computed tomography scan in axial and coronal planes showed that left atrium and pulmonary veins were compressed by ascending and descending aortic aneurysms. Herein, we illustrated this rare condition diagnosed by transthoracic echocardiography in combination with computed tomography.

[Cardiac congestion due to compression of the left atrium by an endoleak following endovascular aortic repair (EVAR)]

In rare cases, global cardiac decompensation is the only sign of a relevant endoleak after endovascular aortic repair (EVAR) therapy from a thoracic aortic aneurysm due to a mechanical compression of the left atrium. In this case report, we describe such an unusual course of disease and we point out the importance of early bed-side echocardiography in the emergency department for immediate diagnostic and therapeutic planning.

An unusual cause of cardiogenic shock: Left atrial compression by a spontaneous rupture of an aneurysm of the descending thoracic aorta

A 77-year-old woman presented with a feverish hemodynamic collapse, acute respiratory distress, and dorsal pain, initially treated as a septic shock. Transthoracic echocardiogram revealed an impressive compression of the left atrial cavity, by an extrinsic mass preventing the left ventricle from refilling. Thoracic computed tomography revealed a large hemomediastinum emerging from an aneurysm of the descending thoracic aorta compressing the left atrium. The patient died in refractory cardiogenic collapse. <Learning objective: In the management of cardiovascular collapse, the understanding of the mechanism or the cause is essential. For this purpose, echocardiogram is a fast and indispensable tool, sometimes allowing discovering surprising etiology.>.

Left atrial impression: a sign of extra-cardiac pathology

Compression of the left atrium by extra-cardiac structures is a rare cause of dyspnoea or reduced exercise tolerance and can easily be visualized by transthoracic echocardiography (TTE). An impression of the left atrium visualized by TTE could be the first indication of the presence of a pathological structure dorsal to the left atrium; such a structure can, in time, compress the left atrium. The existence of this phenomenon and its clinical implications will be reviewed. The impressing structures are divided into four anatomic groups: (i) gastrointestinal structures, which are the most common, (ii) mediastinal structures, (iii) aorta and intrapericardial structures, and (iv) pulmonary structures. Explanatory examples of left atrial impression with different causes and various levels of severity are presented.

Left Atrial Compression by Dissecting Aneurysm of the Ascending Aorta

We report a case of a 39-year-old man with extensive left atrial compression by a dissecting aneurysm of the ascending aorta. Presumably this compression caused hypotension. A dissecting aneurysm of the ascending aorta, limiting left ventricular inflow by left atrial compression, has not been described in English-language medical literature before.

Right pulmonary vein and biatrial compression by a massive descending aorta aneurysm

Compression of superior vena cava, oesophagus and bronchus is well known, but atrial compression, especially left sided, in combination with right pulmonary vein compression is very rare. We report an unusual case in a Marfan patient of extrinsic biatrial and pulmonary vein compression caused by a descending thoracic aneurysm.

Left Atrial Compression by Thoracic Aneurysm Mimicking Congestive Heart Failure

Most patients with thoracoabdominal aortic aneurysm are asymptomatic and this aneurysm has rarely been reported as a cause of congestive heart failure. We present an infrequent case of extrinsic left atrial compression caused by a descending thoracic aneurysm diagnosed by transthoracic echocardiography as a cause of heart failure.