This document discusses left atrial enlargement as seen on clinical imaging. It presents 3 figures showing examples of left atrial enlargement in patients with mitral stenosis and mitral insufficiency. Figure 1 shows double contouring of the left atrium on chest x-ray in a patient with mitral stenosis. Figure 2 shows indentation of the esophagus by an enlarged left atrium in another patient with mitral stenosis. Figure 3 demonstrates cardiomegaly with enlarged left atrium and left ventricle in a patient with mitral insufficiency.

1. 3Left Atrial Enlargement

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig CA 3-1 Mitral stenosis. (A) Frontal chest
radiograph demonstrates a double contour
(arrows) representing the increased density of
the enlarged left atrium. (B) Lateral view
confirms the left atrial enlargement (arrows)
in this patient with rheumatic heart disease.

4. • Fig CA 3-2 Mitral stenosis. (A) On a lateral
view, the enlarged chamber produces a
discrete posterior indentation (arrows) on the
barium-filled esophagus. (B) In another
patient, there is associated calcification of the
mitral valve annulus (arrows).

5. • Fig CA 3-3 Mitral insufficiency. (A) Frontal and (B)
lateral views of the chest demonstrate gross
cardiomegaly with enlargement of the left atrium and
left ventricle. Note the striking double-contour
configuration (open arrows, A) and elevation of the left
main bronchus (closed arrows, B), characteristic signs
of left atrial enlargement. The aortic knob is normal in
size, and there is no evidence of pulmonary venous
congestion.