Enlarged left atrium: symptoms, causes

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The left atrium is located in the upper left side of the heart. It is one of the four chambers of the heart . Too high pressure or too much blood volume can cause the left atrium to enlarge, leading to an enlarged left atrium (LAE).

The increase in pressure or volume is caused by underlying cardiovascular disease; Finding out that someone has LAE should trigger a search for the condition that is causing it.

Left and right atria of the heart.

Symptoms of left atrial enlargement

Sometimes an enlarged atrium does not cause any symptoms. The appearance of symptoms depends on the degree of enlargement of the left atrium. If the increase in size is significant, symptoms are likely to appear. If symptoms are noticeable, they may include:

  • Chest pain
  • Breathing problems, including shortness of breath and coughing.
  • Exhausted
  • Abnormal heart beat
  • Accumulation and swelling of fluids.
  • Fainting

But these symptoms are also common in numerous conditions that affect the heart, including congestive heart failure . Another symptom LAE can cause is dysphagia , or difficulty swallowing, caused by exposure of the esophagus to a greatly enlarged atrium.

LAE is usually the result of underlying cardiovascular disease and is often found when tests are done to identify these underlying conditions.

Science Picture Co / Getty Images

Causes

The health conditions most commonly associated with left atrial enlargement include high blood pressure, atrial fibrillation, mitral valve dysfunction, and left ventricular problems. These conditions can cause increased pressure in the left atrium, increased volume of the left atrium, or both, resulting in LAE.

Although aging, gender, and body size affect the size of the left atrium, these are not causes or risk factors for LAE. Heart disease can cause LAE regardless of your age, gender, or body size.

High blood pressure

High blood pressure is common in people with LAE. A 12-year review of 15 studies in the American Journal of Hypertension found that LAE is present in 16-83% of people with high blood pressure. In people with high blood pressure, LAE is often associated with asymptomatic diastolic pressure. dysfunction.

Atrial fibrillation

Atrial fibrillation (A-Fib) is a problem that causes arrhythmias or irregular heartbeats. This causes the two upper chambers of the heart to beat differently than the two lower chambers. Sustained fiber A can eventually enlarge the left atrium.

A-Fib can be permanent, persistent, or paroxysmal, and the latest research suggests that LAE is both a cause and a complication of A-Fib. An analysis of a large study by the British Cardiovascular Society examined risk factors for heart disease .

The data covered a variety of heart conditions, including A-Fib. The researchers examined the size of the study participants' left atria. They found that enlarged atria are common in people with A-Fib.

According to the results, people with an enlarged left atrium are 60% more likely to develop A-Fib, and people with severely enlarged atria are four times more likely than people with normal chambers. Researchers confirm that an enlarged left atrium is an independent risk factor for A-Fib, as are stroke and heart failure.

A second study from 2018 confirmed these findings, adding that an enlarged left atrium is a predictor of A-Fib .

A study published in the International Journal of Cardiology finds evidence that LAE may also be a consequence of A-Fib. In this study, the researchers were able to determine that left atrial changes were common in people with A-Fib and occurred slowly and gradually .

Mitral valve dysfunction

Several conditions associated with the mitral valve can contribute to the development of LAE. The mitral valve is the heart valve between the left atrium and the left ventricle. Mitral stenosis causes a narrowing of the mitral valve and makes it difficult to fill the left ventricle.

On the other hand, mitral regurgitation causes blood to leak from the left ventricle to the left atrium. Both conditions make it difficult for blood to pump from the left atrium to the left ventricle, causing increased pressure in the left atrium and eventually causing it to expand.

The link between mitral valve problems and LAE is common. A 2013 study found that in people with mitral valve disease and asymptomatic LAE, mitral valve replacement can reduce the size of the left atrium and help prevent the symptoms caused by LAE.

Left ventricular problems

Left ventricular problems put pressure on the left atrium, causing the left atrium to enlarge. Left ventricular and left atrial problems seem to go hand in hand.

For example, a 2019 study published in the Journal of the American Society of Hypertension found that people with left ventricular hypertrophy (LVH) have higher systolic blood pressure (SBP) and a large left atrium .

SVH is a condition in which the muscle wall of the heart's left chamber, the ventricle, thickens. SBP is the number at the top of the blood pressure reading that indicates the amount of pressure that the blood exerts on the vessels during the heartbeat.  

Diagnostics

LAE can be diagnosed by looking at the heart with an echocardiogram. This test uses ultrasound to photograph the heart.

The test is done with a person lying on a table and a technician placing metal electrodes on the person's chest. The technician will then pass a small sound wave probe over your chest.

These sound waves reflect off the heart and echo back to the probe, creating images. An echocardiogram is a safe, painless, harmless procedure with no side effects.

Other tests that can be used to diagnose LAE include magnetic resonance imaging (MRI) and computed tomography (CT). These tests measure the left atrium to determine its size and whether it is enlarging from its normal size.

Watch out

Treatment of left atrial enlargement aims to identify and eliminate its cause:

  • Treatments for high blood pressure : High blood pressure is treated with medications and unhealthy habits , including a healthy low-salt diet. It also includes limiting alcohol consumption, exercising, managing stress, and quitting smoking.
  • Treatment for mitral stenosis : Treatment options for mitral stenosis include diuretics to reduce fluid, anticoagulants to prevent blood clots, and antiarrhythmics to control irregular heartbeats. Also, surgery can repair or replace the mitral valve.
  • Treatment for mitral regurgitation : Treatment for mitral regurgitation includes medications that reduce the risk of blood clots. Like mitral stenosis, surgery can fix the problem.

Get the word of drug information

Most people with an enlarged left atrium have no symptoms. The presence of LAE is usually a sign of underlying heart disease. Treatment for LAE-related conditions ranges from lifestyle changes to medications and surgery.

LAE can also put people at risk for additional heart problems, so it's important to keep your blood pressure and heart rate under control. If you have heart problems in your family, be sure to tell your doctor. In this way, it will be possible to closely monitor the health of your heart.

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