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Left atrial enlargement

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The chest X-ray is a good method for assessing the size of the left atrium.

Signs of left atrial enlargement on chest X-ray include:

  • increased density in the region of the left atrium; the increased density extends to the right of the spine

  • a curvilinear border of the left atrium is seen through the right heart; this is a visible right-hand margin of the left atrium
  • left mainstem bronchus is more horizontal on PA chest radiograph, occasionally there is widening of the carinal angle (normal is 80ø)

Causes include:

  • obstruction at the left atrial level
    • mitral stenosis or regurgitation
    • atrial myxoma
    • cor triatriatum
  • left ventricular failure
  • aortic stenosis or regurgitation
  • co-arctation of the aorta

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