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Can left atrial enlargement have symptoms?

Sounds kind of a silly question I know but mine seem more like atrial fib symptoms. They started after some exercise two nights ago. Shortness of breath, nausea, weakness to the point of almost faint, and racing heart. No chest pain though. I also then got the chills and more short of breath when I laid down. Things seemed to subside and I got a ECG the following day, which said probable left atrial enlargement. I am waited for Echo and holter monitor. But until then I still have some minimal strange heart racing episodes and sob at times, a repeat ECG done again today said at that time it was normal. So confused..........anything you may be able to share with me......thanks so much!!!

7 Replies


It is feasible the AF caused the left atrial enlargement. Alternately the left atrial enlargement might have caused the AF. There the circle starts. The trick is to find out which came first, because the left atrial enlargement might be caused by something else. I'm not sure how they can tell about the left atrial enlargement from an ecg, until the echo.

Your symptoms are typical altho everybody with AF has different variety of symptoms. In your case the AF seems to come and go. Episodic. Or as they call it Paroxysmal.

Once they got the info treatment will commence. Be prepared. Cardinal rule no 1 is DON'T PANIC, and don't worry. It might be uncomfortable and difficult but hopefully the right course of treatment will enable correct management of this problem. Obviously you are worried about your mortality. Don't be. But if you are, ask them straight out to clear your mind.

Sobbing, is more a personal thing between you and the upset of this awkward change.

Best to you.



Pip's right, try not to worry too much, it's not a nice condition but it's rarely fatal thank goodness. Usually the hospital do an echo cardiogram to check your valves are working properly and so on. You'll find some of the symptoms are due to the stress and upset rather than the condition per se. Hoping that they give you a firm diagnosis soon - don't be shy about reminding them that just because the ECG is okay sometimes doesn't mean you don't have AF, or something similar!


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HI - as Phil says, left atrial enlargement may have caused AF or vice versa. Left Atrial enlargement is part of a set of conditions that are associated with dilated cardiomyopathy (DCM). You can find a lot more information about this on the Cardiomyopathy website cardiomyopathy.org/ It is often accompanied by AF

In my case I was diagnosed with both DCM and AF and the cardiologist at Harefield was unable to say which had occured first and diagnosed the cause as a probable heart virus - but this seem to be the default assumption when they can't find anything else and it's not considered desirable to do a biopsy to check as this is too invasive!

I had similar symptoms to you (probably worse) and was a little worried when they were categorised by the A&E consultant as heart failure - but this is a generic way of referring to these symptoms.

I still have the AF 12 years later after 5 cardioversions, drug therapy with amiodarone and several long periods of being AF free, but the DCM / atrial enlargement has virtually disappeared after treatment with drugs and moderate exercise.

My cardiologist said that as a rule of thumb if the enlargement is up to 50% of normal size it tends to recover to near normal size after treatment


Are you sure you're not reading my case notes ? Almost identical probs.

My DCM reversed. In my case, alcohol was the cause. But left with AF / Flutter, and no end of treatments



Thanks for all the help, and sharing of your personal stories!! I am trying to stay calm, I guess the not knowing part is hard to not think about. I am a new Rheumatoid Arthritis patient since last fall and had my first flare up that lasted 4 weeks, then a spell with indigestion/acid reflux that sent me to emerg, and just when I was thinking of how well I feel now that the flare up is over, this heart issue emerges.

I couldn't lay down last night everytime I did, my heart quivered and pounded hard off and on. It was worse on my left side. So I stayed upright til 2am then managed to lay on my right sore shoulder and things settled out. But this am, heart feels pretty good, but now have some sort of muscle spasm happening in my back behind my heart and lung area, which hurts to breath.......arrggg......took an epsom salt bath and a meloxiocam......hope it settles soon. I guess when it rains it pours......I am not a person to have much wrong with them at all, and only 37 years old and active. Anyways, hoping it will all come together just fine. Thanks for all your support :)



I had a similar problem when lying down. Every time I tried to sleep, I would suddenly wake up with a jump & my heart pounding until I sat up. I was treated initially as if I had a heart attack with Digoxin. If it continues you need to go to A&E.

I too didn't have any chest pains, but the inability to lie down without my heart pounding I was told was one of the symptoms of heart failure (din't get too worried about the terminology - it just means that the heart isn't working efficiently)

Hope things settle if not do go to A&E



Thank you Lance!! I think I am going to go see doctor again today, as this so called 'muscle spasm' in my back I think is fully lung related. I think my RA may have advanced to effect my heart and lungs possibly. Will get it checked out for sure!! Thanks so much all!! :)


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