Cor Vasa 2014, 56(1):e80-e83 | DOI: 10.1016/j.crvasa.2013.06.008

Mediastinal abscess compressing the left atrium: A case report and literature review

Jan Simonides^a,*, Josef Šach^b, Blanka Rosová^c

^a III. interní-kardiologická klinika, Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

^b Ústav patologie, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

^c Ústav patologie, Thomayerova nemocnice, Praha

The left atrium is a thin-walled cardiac chamber with a low intraluminal pressure. It is located in the inferoposterior part of mediastinum, near to structures such as the esophagus and descending aorta. This makes it vulnerable to compression by pathologic changes associated with the gastrointestinal tract, mediastinum, lungs, pericardium and aorta. Depending on the level of the compression the patient may be asymptomatic or develops signs of cardiac insufficiency. We describe a lethal course of left atrial compression due to a chronic mediastinal abscess secondary to a ruptured esophageal ulcer. To our knowledge this is the first such case described, in part because bordered mediastinitis with abscess development is very rare.

Keywords: Abscess; Esophagus; Heart failure; Left atrial compression; Mediastinum; Metastases to the heart

Accepted: June 25, 2013; Published: February 1, 2014  Show citation