02124nas a2200229   4500008004100000024000700041245014700048210006900195260001800264300001200282490000700294520136300301653002801664653002201692653002801714653002501742653002001767100002301787700002301810700002101833856004001854       2022                        eng d  a2300aErlenmeyer-shaped Heart in a Patient with Giant Left Atrium due to Mixed Mitral Valve Pathology: A Neglected Case in a Rural Area in Indonesia0 aErlenmeyershaped Heart in a Patient with Giant Left Atrium due t  cDecember 2022  a829-8320 v143 a<p class="rtejustify">Giant left atrium (GLA) is a rare condition typically found in patients with rheumatic mitral valve disease. On chest radiographs, this condition often mimics another cause of cardiomegaly. A 52-year-old man was admitted to the hospital with complaints of shortness of breath and orthopnea. Mid-diastolic and grade IV pansystolic murmurs could be heard at the apex radiating to the axilla on cardiac auscultation. The electrocardiogram showed a junctional tachycardia rhythm, while the chest radiograph displayed extreme cardiomegaly with Erlenmeyer-shaped heart. Massive pericardial effusion was suspected. Transthoracic echocardiography (TTE) was then performed, revealing GLA with a left atrial volume index (LAVi) of 1101 ml/m2. Meanwhile, transoesophageal echocardiography (TEE) confirmed calcification of P2 and P3 extending to the border of the mitral leaflet up to one third of the chordae tendineae, with moderate mitral stenosis and eccentric mitral regurgitation jet due to prolapse of A2. The patient was treated with optimal medical therapy while awaiting cardiac surgery. GLA is a rare complication of mitral valve disease and an almost forgotten cause of cardiomegaly. Diagnostic imaging procedures with echocardiography are a less invasive and readily available modality to establish the diagnosis of cardiomegaly.</p>
10aErlenmeyer-shaped heart10aGiant left atrium10aJunctional tachycardia.10aMitral regurgitation10aMitral stenosis1 aRomdiyana, Aprilia1 aBudiarto, Mohammad1 aChandra, Evelyne  uhttps://www.phcogj.com/article/1916