The left or right atrium may become infarcted but this often goes unrecognized. Often the first indication for an atrial infarct is the development of a complication.
Features of atrial infarction:
(1) Most cases occur in conjunction with ventricular infarction, but sometimes only the atrium is infarcted.
(2) The right atrium is affected about 5 times more often than the left atrium.
(3) The auricle is often involved and may be the site of thrombus formation.
Transesophageal echocardiography may be helpful in making the diagnosis.
Complications of an atrial infarction:
(1) rhythm disturbance (supraventricular tachycardia, sinus arrest, sinus tachycardia, sinus bradycardia, atrial fibrillation, wandering atrial pacemaker, disturbance in atrioventricular conduction)
(2) thrombosis followed by embolization (pulmonary embolism with a right atrial infarct, systemic embolism with a left atrial infarct)
(3) rupture of the infarcted atrium
(4) heart failure due to a loss of the "atrial kick"
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