Left Atrial Enlargement

What is left atrial enlargement?

Left atrial enlargement is when one of your heart chambers gets bigger than normal. This happens over time when your left atrium tries to adjust to issues such as high blood pressure in the rest of your heart.

Sometimes, you may have a problem with your left ventricle, which pumps blood to your aorta. Other people may have something wrong with their mitral valve, which lets blood move between your left atrium and left ventricle. These issues can create high pressure and/or a large volume of blood in your left atrium.

Your left atrium can get larger and stretch when it tries to adapt to make up for this high pressure and/or high volume. This stretching causes scarring and injury to your atrium. It’s like a big brother who tries to help his siblings carry the load but ends up getting hurt himself.

Who does left atrial enlargement affect?

Left atrial enlargement affects people with:

• High blood pressure.
• Mitral valve disease.
• Aortic valve disease.
• Coronary artery disease.
• Certain kinds of cardiomyopathy.
• Diastolic dysfunction.
• Left ventricular hypertrophy.
• Congenital heart disease.

How common is left atrial enlargement?

An Italian study of adults found that 12% of them developed left atrial enlargement during a period of 10 years. Based on this, researchers believe the condition isn’t rare in the general population. In the study, most of the people who developed left atrial enlargement were in their 40s and 50s.

What are the symptoms of left atrial enlargement?

Left atrial enlargement doesn’t have symptoms, but you can have symptoms of the condition causing it. These symptoms include:

• Fainting.
• Tiredness.
• Heart palpitations.
• Weight gain.
• Difficulty breathing.
• Swelling in your arms or legs.

Left atrial enlargement can cause medical problems such as arrhythmias or abnormal heart rhythms. These involve symptoms that include:

• Palpitations.
• Chest fluttering.
• Chest pain.
• Fainting.

What causes left atrial enlargement?

Conditions you’re born with (congenital) or develop later can cause left atrial enlargement. These conditions include:

• High blood pressure.
• Aortic valve stenosis (narrow aortic valve).
• Mitral valve stenosis.
• Mitral valve regurgitation.
• Mass or tumor in your left atrium.
• Arteriovenous fistulas (a connected vein and artery that exchange blood without using capillaries between them).
• Athlete’s heart (consistent training increases your heart size).
• Diastolic dysfunction in the left ventricle.
• Left ventricular failure.
• Ventricular septal defect.
• Patent ductus arteriosus.

How is left atrial enlargement diagnosed?

Your healthcare provider can use an electrocardiogram (EKG/ECG) to diagnose left atrial enlargement. One of the signs of left atrial enlargement on an ECG is an unusual “P wave.”

If you have this condition, the P wave that represents your atria contracting is longer than normal. It should be shorter than 120 milliseconds. If it’s equal to or longer than that, you may have left atrial enlargement.

What tests will be done to diagnose left atrial enlargement?

Your healthcare provider can confirm your left atrium is enlarged with these tests:

• Electrocardiogram (EKG).
• Transthoracic echocardiogram (TTE).
• Cardiac CT (computed tomography).
• Heart MRI.

How is left atrial enlargement treated?

Healthcare providers don’t have a specific treatment for left atrial enlargement. They can’t reverse it if it’s gone on for more than a week. However, they can treat the condition that’s causing it.

Treatments may include:

• Exercising often.
• Stopping the use of tobacco products.
• Eating foods low in salt.
• Drinking less alcohol.
• Taking blood pressure medicines.
• Having procedures or surgery to fix valve issues.
• Taking medicine to relieve symptoms of valve problems.
• Taking blood thinners (anticoagulants) to prevent a stroke.
• Taking medications for congestive heart failure.

Complications/side effects of the treatment

Any healthy lifestyle changes you make will help you, not hurt you. However, the medicines you take can give you side effects.

Side effects of drugs for treating what causes left atrial enlargement include:

• Dizziness.
• Fainting.
• Abnormal electrolyte levels.

Most surgeries have a risk of bleeding or infection. Valve repair or replacement risks include:

• Heart attack.
• Stroke.
• Kidney failure.
• Abnormal heart rhythm.

Some of these complications can be fatal.

How long does it take to recover from this treatment?

You may need to spend several days to a week in the hospital after a valve repair or replacement. It can take two or three months to recover, depending on the procedure.

How can I prevent left atrial enlargement?

Keeping your heart healthy and preventing the heart issues that cause left atrial enlargement can reduce your risk.

One study suggested that you may be able to prevent left atrial enlargement if you:

• Keep your blood pressure in a normal range.
• Keep your weight at a healthy level.
• Prevent left ventricular hypertrophy.
• Stop smoking.
• Moderate your alcohol intake.

What can I expect if I have left atrial enlargement?

Researchers have found that if you have left atrial enlargement, you’ll get heart issues in the future, such as:

• Heart failure.
• Atrial fibrillation.
• Hypertensive heart disease.
• Stroke.

Knowing this, you can work with your healthcare provider to make a plan for improving your heart health now.

How serious is left atrial enlargement?

Left atrial enlargement itself isn’t a serious problem, but it’s an indicator of one. If you have this condition, it’s important to find out the cause and treat it. It can also lead to problems in the future if you don’t treat the underlying causes.

Can you live with left atrial enlargement?

Yes, but you need to find out what caused it. Once you know the cause, you can get treatment for it.

When should I see my healthcare provider?

Your healthcare provider will want to do annual exams and echocardiograms, even if you don’t have symptoms. You should call 911 if you think you’re having a stroke or heart attack.

What questions should I ask my doctor?

• What caused my left atrial enlargement?
• What’s the best treatment for me?
• Should my family get checked for left atrial enlargement?

A note from Cleveland Clinic

If your healthcare provider diagnoses you with left atrial enlargement, take it as a warning sign. When you know the cause, you can set up a plan with your provider to treat it. It’s always a good idea to take care of your heart. This can mean parking farther away from a store, so you walk more. It can also mean skipping the fries and having a side salad instead. Your provider may prescribe medication to bring your blood pressure down. Controlling blood pressure is a big step toward improving your health.