Massive left atrial calcification: a case report and review of the literature.

Left atrial (LA) calcification is mostly observed in patients with rheumatic mitral valve (MV) diseases who underwent surgical treatment. We report a case of LA calcification in a 69-year-old woman presented with dyspnea and cyanosis. Admission electrocardiogram showed atrial fibrillation and biventricular hypertrophy. Her chest roentgenogram revealed cardiomegaly and a curvilinear whitish shadow in the area of LA. Transthoracic echocardiography revealed severe mitral stenosis and massive LA thrombosis. The patient underwent an emergent surgery, during which the whitish line on chest roentgenogram proved to be a calcified LA inner wall. During an on-pump surgery with cardioplegic arrest, she underwent open MV commissurotomy along with the excision of calcified LA wall and clots. The patient was discharged with no complications. Literature reviews showed that this entity is mainly observed in patients with rheumatic heart disease and presented with respiratory symptoms. The diagnostic modalities, management, and prognosis of previous cases were summarized.