Isolated Rheumatic Mitral Regurgitation with Giant Left Atrium in Sinus Rhythm – A Case Report (original) (raw)

Isolated mitral regurgitation is a relatively uncommon presentation of chronic rheumatic heart disease 1. Chronic nature of rheumatic mitral regurgitation causes gradual dilatation of the left atrium with little increase in pressure and therefore relatively fewer symptoms. However, occasionally the dilatation of LA is so severe, it is termed giant LA. Giant left atrium is a rare condition, with a reported incidence of 0.3%, and occurs following mainly rheumatic mitral valve disease 2. Atrial fibrillation is almost always present 3 predisposing to thromboembolic complications. A subset of patients may develop severe dysphagia from esophageal compression or hoarseness from laryngeal nerve impingement 4. Here we are presenting a case of isolated mitral regurgitation with giant left atrium in sinus rhythm. Case Report|: A 30-year-old woman normotensive, non-diabetic presented with the complain of SOB and palpitation for 2 ½ months and leg swelling for 10 days. 2 ½ months back, after 10 days of delivery of her 3 rd child, she developed SOB which was initially present on exertion (NYHA-II) and relieved by rest, but since last 10 days, it was present on minimal exertion or rest (NYHA III-IV) with orthopnea but no PND. She also had dry cough but no hemoptysis or diurnal and seasonal variation. She also had palpitation which occurred with SOB during exertion and was relieved by rest. It was regular and not associated with dizziness or syncope. Since last 10 days, she also developed swelling of legs which was gradually increasing, associated with decreased urine output but no puffiness of face or abdominal swelling. She didn't have history of chest pain,