[First diagnosis of an aneurysm of the left atrial appendage in a 69-year-old female patient].
METHODS
A 69-year-old woman was admitted to hospital for cardioversion of persistent atrial fibrillation. She was on anticoagulation with a vitamin K antagonist for several weeks. Transesophageal echocardiography revealed a left atrial appendage aneurysm with a floating thrombus. None of the risk factors for thromboembolism mentioned in the guidelines for the management of patients with atrial fibrillation were present. As the patient refused surgical resection, long-term anticoagulation was recommended.


CONCLUSIONS
Due to their scarcity, patients with left atrial appendage aneurysms are not considered in current management guidelines. Since this anomaly is associated with a potential risk of systemic embolization, surgical resection should be recommended even in asymptomatic patients.
Miljak
Tomislav
T
Klinik für Innere Medizin III (Kardiologie), Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Villingen-Schwenningen, Germany. Tomislav.Miljak@sbk-vs.de
Kunze
Markus
M
Birkemeyer
Ralf
R
Jung
Werner
W
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D002908:Chronic Disease; D004452:Echocardiography; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008134:Long-Term Care; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy
D000925:Anticoagulants