Abstract

A 73-year-old woman was brought to the emergency unit due to shortness of breath. A diagnosis of pneumonia was made, and she was transferred to the intensive care unit. As for past medical conditions, she had chronic kidney disease and valvular heart diseases. In Previous years, she was recommended to undergo mitral valve surgery due to severe mitral regurgitation; however, she refused the surgical treatment and was given medication. Given valvular heart disease history and increased cardiothoracic index in the chest x-ray, transthoracic echocardiogram was performed. A giant left atrium (10.3*11.3 cm) alongside severe eccentric mitral regurgitation was recorded. The opacity occupying the entire lower zone of the chest x-ray was attributed to the giant left atrium. Occupation of the right side of chest by progressively enlarging the left atrium in the x-ray can be seen in the three chest radiographs taken since 2017. This image can be mistaken with tumor, pneumonic infiltration, and atelectasis.