• Vol. 34 No. 10, 642–645
  • 15 November 2005

Beyond Ortner’s Syndrome – Unusual Pulmonary Complications of the Giant Left Atrium

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ABSTRACT

Introduction: The giant left atrium (GLA) is a complication of severe mitral valve disease and causes morbidity by compressing adjacent intra-thoracic structures. Clinical Picture: We report 2 cases of unusual pulmonary complications of the GLA. Case 1 developed recurrent collapse of the left lung due to left main bronchus compression. Case 2 was diagnosed with right middle lobe compression and collapse. Treatment and Outcome: Case 1 was successfully treated by mitral valve replacement and left atrial reduction surgery. Case 2 was treated conservatively. Conclusion: Pulmonary atelectasis may occur in patients with GLA due to bronchopulmonary compression. Surgical management with valve replacement and atrial reduction may be necessary to relieve airway compression.


The giant left atrium (GLA) is a complication of severe mitral regurgitation most commonly due to rheumatic heart disease. It causes morbidity by compressing adjacent intra-thoracic structures. Examples include Ortner’s syndrome due to compression of the left recurrent laryngeal nerve, and dysphagia from oesophageal compression. We report 2 unusual cases of lung collapse due to bronchopulmonary compression by the GLA.

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