INTRODUCTION
Enlarged left atrium (LA) is a common finding in severe mitral stenosis (MS) and severe mitral regurgitation (MR). It can expand to giant proportions. The unusual finding in our thirty-year-old female presenting with only mild dyspnea despite markedly dilated LA prompted us to report this case. The chamber was so enormous that it was challenging to interpret the cause of the enlarged cardiac silhouette on the chest radiography.