Echocardiographic evaluation of the atria and appendages
- Elyse Foster, MD
Elyse Foster, MD
- Professor of Clinical Medicine
- University of California, San Francisco
Imaging of the right and left atria and their appendages can provide important diagnostic and prognostic information. Left atrial imaging is especially important in patients with atrial fibrillation who are at increased risk for thromboembolic events resulting from left atrial or atrial appendage thrombus. Imaging of the left atrium has gained increased importance in association with new investigational procedures for atrial appendage occlusion in patients with atrial fibrillation used for stroke prophylaxis.
This topic will review the echocardiographic evaluation of the right and left atria and their appendages. The role of echocardiography in atrial fibrillation is discussed in detail elsewhere. (See "Role of echocardiography in atrial fibrillation".)
The left atrium can be easily imaged in a number of views by transthoracic (surface) or transesophageal echocardiography. In addition to being a site of thrombosis in atrial fibrillation, the left atrium can be involved in a number of disease processes:
●It commonly dilates with age through a process that seems to be linked to "senile" left ventricular diastolic dysfunction and other diseases affecting the left ventricle such as hypertrophic, dilated, or restrictive cardiomyopathy.
●Left atrial dilation occurs in association with chronic atrial fibrillation, Dilation can promote atrial fibrillation by perturbing propagation of orderly depolarization . Conversely, permanent atrial fibrillation can promote LA dilation. (See "Mechanisms of atrial fibrillation".)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- LEFT ATRIUM
- M-mode echocardiogram
- - LA dimension
- Two-dimensional echocardiography
- - LA volume
- - LA thrombus
- Transesophageal echocardiography
- - Detection of thrombi
- - Thrombus in sinus rhythm
- - Left atrial masses and tumors
- LEFT ATRIAL APPENDAGE
- Left atrial appendage function
- RIGHT ATRIUM
- Right atrial thrombus
- Right atrial tumors
- VENA CAVA
- SUMMARY AND RECOMMENDATIONS