[First diagnosis of an aneurysm of the left atrial appendage in a 69-year-old female patient].

CASE REPORT: A 69-year-old woman was admitted to hospital for cardioversion of persistent atrial fibrillation. She was on anticoagulation with a vitamin K antagonist for several weeks. Transesophageal echocardiography revealed a left atrial appendage aneurysm with a floating thrombus. None of the risk factors for thromboembolism mentioned in the guidelines for the management of patients with atrial fibrillation were present. As the patient refused surgical resection, long-term anticoagulation was recommended.

CONCLUSION: Due to their scarcity, patients with left atrial appendage aneurysms are not considered in current management guidelines. Since this anomaly is associated with a potential risk of systemic embolization, surgical resection should be recommended even in asymptomatic patients.