Giant Congenital Left Atrial Aneurysm in an 11-Year-Old Boy

An 11-year-old boy was referred to our hospital for near syncope. He was generally healthy before. On physical examination, his consciousness was clear, and there was no focal neurological deficit. The heart beat was irregular. ECG showed atrial flutter with variable ventricular response (Figure 1A). Cardiomegaly was noted on chest x-ray, with cardiac apex pointing toward the left side (Figure 1B). However, the transthoracic echocardiography showed that the location of presumed cardiac apex on chest x-ray was actually occupied by an extremely dilated left atrium (LA). The cardiac apex was pointed toward the right side of the chest. Mild to moderate mitral valve regurgitation was found, but the morphology and opening of both mitral leaflets appeared normal. Computed tomography confirmed the diagnosis of a giant LA aneurysm with rightward shift of the cardiac apex (Figure 1C and 1D). The …