Idiopathic Right Atrial Enlargement with Sinus Node Dysfunction

Volume 4, Jan 2015

S. R. Mittal, DM Cardiology, Ajmer, India

 A 43-year-old asymptomatic male was referred for cardiac evaluation for bradycardia. Pulse rate was 34/ minute. Rest of the clinical examination was normal. Electrocardiogram revealed regular slow junctional rhythm at a rate of around 34/ minute. P wave was not visible and QRS was narrow (0.08 sec) (Fig 1). On Holter monitoring there was no atrial activity and QRS rate varied between 34 to 38/ minute. Patient did not agree for further evaluation. However, there was no change in pulse rate after walking for six minutes. Echocardiography revealed unexplained isolated enlargement of right atrium (Fig 2). Other cardiac chambers were normal (Fig 3). All cardiac valves were normal. There was no evidence of pulmonary artery hypertension.

Volume 4, Number 1, Pages: 21-3