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The relationship of displacement of the esophagus to left atrial volume and heart size in persons with mitral stenosis

1956; Elsevier BV; Volume: 21; Issue: 4 Linguagem: Inglês

10.1016/0002-9343(56)90070-5

1555-7162

Louis A. Soloff, Jacob Zatuchni,

Cardiac Arrhythmias and Treatments

D ISPLACEMENT and compression of the esophagus by an enlarged left atrium was first demonstrated by Kovacs and Stoerckl in 1910. These investigators made plaster casts of the esophagus at the autopsy table. They also used the roentgenologic technic to observe the outline of the opaque esophagus in the living. They differentiated the esophageal impression of a large left atrium from that of the normal left atrium and also from that of generalized cardiac enlargement. These studies have been abundantly verified. More recently, the roentgenologic anatomy of the esophagus in health and in disease of the heart and great vessels has been comprehensively described by Evans2 and by Segers and Brombart.3 Observations of the opaque esophagus have now become a routine part of cardiac study. Nevertheless, the precise relationship of the degree of displacement of the esophagus to the degree of left atria1 enlargement has never been established. The impression has been created that the degree of displacement of the esophagus in mitral stenosis may be used as an index of the degree of left atria1 enlargement, provided the displacement is not due to a non-cardiac cause. There is no basis for this opinion because, previous to the introduction of simultaneous biplane stereoscopic angiocardiography, there was no method available to test this assumption in the living. The purpose of this study is to determine the character of displacement of the esophagus in mitral stenosis with and without cardiomegaly and the relationship of its degree to that of the volume of the left atrium. MATERIAL AND METHODS