PARADOXICAL EXPANSION OF THE LEFT ATRIUM IN MITRAL VALVE DISEASE.

Abstract

The fluoroscopic demonstration of left atrial expansion during left ventricular systole has for many years been known to radiologists and cardiologists as an indication of mitral valvular regurgitation. Some have believed it to be reliable evidence of mitral regurgitation and others, especially recently, have considered it to be of little significance. This study is an attempt to evaluate as objectively as possible the validity of this sign, commonly referred to as paradoxical expansion of the left atrium. Expansion of the left atrium at the time of left ventricular systole as a fluoroscopic sign of mitral valvular incompetence is said to have been described in 1901 by Holzknecht, as follows: “…under pathological circumstances one sees not uncommonly an obvious middle prominence with arterial pulsation…one should remember mitral incompetence which produces positive pulsation of the left auricle” (1). Bedford (2) in 1927 and Elkin et al. (3) in 1952 called attention to the usefulness of this finding. Brigd...