Right Atrial Appendage

What is the right atrial appendage?

The right atrial appendage (RAA) is a pouch that extends from the right atrium (upper chamber) in your heart. You may hear about it if a healthcare provider wants to place a pacemaker lead (wire) in your right atrial appendage. This is a good place to put a wire because a provider can get to your RAA easily. Also, it’s near the SA (sinoatrial) node that sends electrical impulses to make your heart beat.

This unfamiliar part of your heart can cause problems for you, but treatments can help just like they do for other areas of your heart.

What does a right atrial appendage do?

The right atrial appendage’s function is to release natriuretic peptides (proteins) when your RAA’s walls stretch from too much blood volume. These peptides make your blood vessels widen. They also increase the amount of salt and water your body clears out through urine (pee). These actions can bring blood volume and pressure down.

Where is the right atrial appendage located?

Your right atrial appendage extends out from the upper part of your heart’s right atrium. Located next to your superior vena cava, your RAA reaches over part of a groove between the right atrium and ventricle.

What are the parts of your RAA?

Your right atrial appendage anatomy consists of a pouch with an opening. Blood moves in and out of your right atrial appendage. Your RAA has ridges of muscle (the terminal crest and musculi pectinati). These create a rough surface inside your RAA.

What does it look like?

Your right atrial appendage can consist of one or more lobes — even as many as six. Researchers estimate its area at around 3 square centimeters (about half a square inch). The RAA’s opening is about 2 centimeters (less than 1 inch).

Right atrial appendage shapes

RAA shapes may include:

• Four-sided (parrot beak, the most common shape)
• Quadrilateral (like a horse head)
• Trapezoid (anvil)
• Triangular (sailboat)
• An undefined shape

Researchers have identified subtypes of these main types as well.

What are the common conditions and disorders that affect your right atrial appendage?

Several conditions can affect your right atrial appendage, like:

• Atrial fibrillation (Afib): This can cause blood clots to form in your RAA, but not as often as in your left atrial appendage.
• An injury from a motor vehicle accident.
• An aneurysm (an overstretched artery).

Common signs or symptoms of RAA conditions

Symptoms from conditions that affect your right atrial appendage may include:

• Chest pain
• Fatigue
• Shortness of breath (dyspnea)
• Dizziness

Common tests to check the health of the right atrial appendage

Tests to check the health of your right atrial appendage include:

• Transesophageal echocardiogram (TEE): This type of echo uses a transducer (probe) in your throat.
• Cardiac CT (computed tomography): This uses X-rays to scan your heart.
• Transthoracic echocardiogram (TTE): This type of echo uses a transducer on the outside of your chest.

Common treatments

Treatments for your right atrial appendage include:

• Anticoagulants, if you have blood clots in your RAA
• Ablation (destruction) of tissue in your right atrial appendage to manage atrial fibrillation that starts there
• Surgery on damaged RAA tissue after an injury

How can I take care of my right atrial appendage?

Your heart is at its healthiest when it gets the everyday care it needs. Examples include:

• Spending 150 minutes per week being physically active.
• Eating foods that are good for your heart.
• Avoiding the use of tobacco products.
• Managing your stress level.
• Treating conditions like high blood pressure and diabetes.