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Heart Chamber Quantification MasterClass


Why is left atrial size important?

Left atrial size is a prognostic factor for atrial fibrillation, stroke, congestive heart failure, and cardiovascular risk in general! 

What are some of the reasons for left atrial dilation?

  • Hypertensive heart disease
  • Atrial fibrillation
  • Mitral valve disease
  • Aortic stenosis
  • Coronary artery disease
  • Dilatative and hypertrophic cardiomyopathy
  • Restrictive cardiomyopathy

Although left atrial size does not always correlate to the severity of the underlying disease process, there is a clear, direct relationship between left atrial size and all-cause mortality!

How to quantify left atrial size?

We can use M-mode, measurements of the left atrial length (2D), the area (2D), the volume (biplane 2D), and 3D echo measurements.

However, before you start measuring, evaluate the LA by eyeballing! It’s not so difficult, and sometimes, you will immediately recognize left atrial enlargement.

Now put your eyeballing skills to the test!

Can you judge which of the left atria shown at the end of the sequence is visually enlarged?

Did you get it right? Here’s the solution: We marked the echo images that show enlarged left atria. Only the last loop shows a normal-sized left atrium!

Ultrasound image of left atrium.

  • What are the clinical implications of LA dilatation? 
  • How to perform measurements of left atrial size?
  • What are the typical locations of thrombus formation, and how to detect them with echo?
  • What other pathologies of the atria and the interatrial septum can you detect with echo?

These are just some of the topics discussed in the chapter on left- and right atrial assessment in our Heart Chamber Quantification MasterClass.


Our Heart Chamber Quantification MasterClass is a comprehensive course that teaches you how to identify wall motion abnormalities, use strain analysis, and interpret left ventricular function in patients who have undergone heart transplantation, among many other essential topics.


Thomas Binder and the 123sonography team

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