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Left Atrial Enlargement
I'd like to learn more about the significance of left arial enlargement.

I am 58 and have had mitral valve prolapse since birth.  My recent echocardiogram showed the following:
LV - Normal size & thickness. LV diastolic & systolic function appear normal.
Mild prolapse of anterior MV leaflet.  MV mildly thickened.  Moderately severe mitral regurgitation.
SEVERE LEFT ATRIAL ENLARGEMENT. LA index 54.  Right atrium normal in size.
Trivial tricuspid regurgitation with no suggestion of pulmonary hypertension.
Pulmonary valve poorly visualized.
Right ventricle normal size & function.
TDS-PLAX & SAX images off axis.  Pectus excavatum.

I have no symptoms of concern.  At the moment, I do not have a follow-up appointment with the cardiologist or my primary care physician.  I'd like to learn more about what my LA enlargement may mean and what follow up may be wise.  Thanks.
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367994 tn?1304957193
Left index 54.  This is a method by index that measures left atrium size by volume.  The usual method with an echo is to measure by dimensions. LA dimension by M-mode or two-dimensional (2D) imaging has been the standard indicator of size for the past few decades, there is increasing recognition that enlargement occurs eccentrically which reduces the sensitivity of this measurement.

Left atrial enlargement can too much blood in the atrium (moderately/severe MVR) would be the most likely cause but there are other causes. Blood back flows into the left atrium with each heartbeat and that reduces the amount of blood pumped into circulation with each heartbeat.  I have a moderate/severe MVR for more than six years and there are no symptoms that warrant intervention.  There is a medical school of thought that a valve operation should be done immediately in order to preserve the left ventrical pumping ability.  Another option is to wait and watch.

Hope this helps

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