The relationship of the left atrium to the opacified esophagus in upright and recumbent positions.

Abstract

It has long been recognized that the close apposition of the posterior surface of the left atrium to the anterior wall of the thoracic esophagus is of diagnostic significance in evaluating enlargement of this cardiac chamber. Earlier investigators (4, 6, 7, 10, 11) have demonstrated adequately the importance of examination of the barium-opacified esophagus, not only in diseases of the heart and aorta but also in differentiating lesions of the right and left sides of the heart. Mitral valvular disease—stenosis, incompetence, or both—is the most common cause for left atrial enlargement. Dilatation of the left ventricle, auricular fibrillation, patent ductus arteriosus, and interventricular septal defect may produce functional changes which enlarge the left atrium. The above conditions do not always cause sufficient left atrial enlargement to produce esophageal deviation in the upright patient (2). Kjellberg (3) believes that lesser degrees of enlargement may become manifest with the patient prone, since in ...