814
IMAGE FOCUS
Image focus
doi:10.1093/ehjci/jev064 Online publish-ahead-of-print 30 March 2015
.............................................................................................................................................................................
Coconut atrium Prem Krishna Anandan, Patel Jigarkumar Shukkarbhai, Prabhavathi Bhatt, and Cholenahally Nanjappa Manjunath* Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
* Corresponding author. Tel: +918861661048; Fax: 080 22977400, Email: [email protected]
Supplementary data are available at European Heart Journal – Cardiovascular Imaging online. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015. For permissions please email: [email protected].
Downloaded from by guest on November 15, 2015
Massive calcification of the left atrial wall, also known as a porcelain atrium, is a rare condition. It is of clinical importance in the setting of mitral valve surgery. We present a case of massive left atrial calcification involving the interatrial septum termed as coconut atrium. A 37 year old female patient, known case of rheumatic mitral stenonis with mitral regurgitation and atrial fibrillation, underwent balloon valvuloplasty in 2002 and had come for a routine follow-up visit after 12 years. A 2D echocardiogram confirmed severe left atrial and left ventricular enlargement, the mitral valve area was found to be 1.6 cm2 (normal 3–4 cm2), and severe mitral regurgitation. Incidental findings on the chest X-ray and fluoroscopy revealed an unusual pattern of cardiac calcification (Panel A and Supplementary data online, Video S1). Subsequently, a non-contrast CT scan of the thorax was obtained for further characterization and anatomical localization (Supplementary data online, Video S2), which showed calcification of the entire left atrium involving interatrial septum, hence called coconut atrium. Familiarity with the radiographical features of this unique distribution of calcium, in the correct clinical setting, will allow prompt recognition when interpreting chest X-rays and CT images. Calcification of the interatrial septum and/or caseous necrosis of the mitral annulus could be potential contraindications for mitral valve surgery.
IMAGE FOCUS
Image focus
doi:10.1093/ehjci/jev064 Online publish-ahead-of-print 30 March 2015
.............................................................................................................................................................................
Coconut atrium Prem Krishna Anandan, Patel Jigarkumar Shukkarbhai, Prabhavathi Bhatt, and Cholenahally Nanjappa Manjunath* Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
* Corresponding author. Tel: +918861661048; Fax: 080 22977400, Email: [email protected]
Supplementary data are available at European Heart Journal – Cardiovascular Imaging online. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015. For permissions please email: [email protected].
Downloaded from by guest on November 15, 2015
Massive calcification of the left atrial wall, also known as a porcelain atrium, is a rare condition. It is of clinical importance in the setting of mitral valve surgery. We present a case of massive left atrial calcification involving the interatrial septum termed as coconut atrium. A 37 year old female patient, known case of rheumatic mitral stenonis with mitral regurgitation and atrial fibrillation, underwent balloon valvuloplasty in 2002 and had come for a routine follow-up visit after 12 years. A 2D echocardiogram confirmed severe left atrial and left ventricular enlargement, the mitral valve area was found to be 1.6 cm2 (normal 3–4 cm2), and severe mitral regurgitation. Incidental findings on the chest X-ray and fluoroscopy revealed an unusual pattern of cardiac calcification (Panel A and Supplementary data online, Video S1). Subsequently, a non-contrast CT scan of the thorax was obtained for further characterization and anatomical localization (Supplementary data online, Video S2), which showed calcification of the entire left atrium involving interatrial septum, hence called coconut atrium. Familiarity with the radiographical features of this unique distribution of calcium, in the correct clinical setting, will allow prompt recognition when interpreting chest X-rays and CT images. Calcification of the interatrial septum and/or caseous necrosis of the mitral annulus could be potential contraindications for mitral valve surgery.
