The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Hemodynamically Significant Extrinsic Left Atrial Compression by Gastric Structures in the Mediastinum

Syed T. Raza; Sandip K. Mukherjee; Peter G. Danias; Jame Abraham; Kevin M. Johnson; Milton J. Sands; Morgan S. Werner; and David I. Silverman
[+] Article, Author, and Disclosure Information

From the New Britain General Hospital, New Britain, Connecticut. The John Dempsey Hospital and University of Connecticut School of Medicine, Farmington, Connecticut. Yale-New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut. Requests for Reprints: David I. Silverman, MD, Cardiology L3108, University of Connecticut Health Center, Farmington, CT 06030. Grant Support: In part by a Young Investigator Award from the Patrick and Catherine Weldon Donaghue Foundation (Dr. Silverman).

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;123(2):114-116. doi:10.7326/0003-4819-123-2-199507150-00006
Text Size: A A A

Extrinsic left atrial compression is an uncommon source of hemodynamic compromise [1] that can be caused by many mediastinal structures, including bronchogenic cysts [23], carcinoma [4], lymphoma [5], thymoma [6], aortic aneurysm [7], and diaphragmatic hernia [8]. To date, however, few cases of gastric structures (stomach, esophagus, or both) causing hemodynamically significant left atrial compression have been reported [9]. We describe three cases of extrinsic left atrial compression by the stomach that caused simultaneous hypotension and congestive heart failure.

First Page Preview

View Large
First page PDF preview


Grahic Jump Location
Figure 1.
Compression and relief of compression of the left atrium in a 60-year-old man. Top.Bottom.

Severe compression of the left atrium 5 days after transhiatal esophagectomy, shown by transthoracic echocardiography in the four-chamber view. Relief of compression after evacuation of the stomach. LA = left atrium; LV = left ventricle.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Obliteration of the left atrium and relief of left atrial compression. Top.Bottom.

Almost complete obliteration of the left atrium by an extrinsic mass in a 94-year-old woman with a known hiatal hernia. Relief of left atrial compression after removal of 800 mL of fluid from the stomach. Ao = aorta; LA = left atrium; LV = left ventricle.

Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.