{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:13:05Z","timestamp":1781194385092,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac calcification has multiple etiologies, including previous myocardial infarction, sepsis, and myocarditis. An imbalance between plasma calcium and phosphorus levels can also lead to cardiac calcification. Patients with pre\u2010existing conditions such as rheumatic heart disease or those who have undergone mitral valve replacement (MVR) are at risk of developing left atrium (LA) calcification. Complications may include pulmonary hypertension and heart failure. The objective of this study is to summarize left atrial calcification, its causes, complications, and therapeutic guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study reviewed relevant literature from Google Scholar and PubMed databases until October 2024, including case series, observational studies, and randomized controlled trials (RCTs). The American Psychological Association (APA) seventh edition guidelines were followed for data presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Coconut LA can arise from various diseases, including rheumatic heart disease, congenital pulmonic valve disease, and MVR. Pathological studies indicate that atrial calcification results from collagen\u2010rich matrices, macrophages, and lymphocytes. Radiological imaging plays a crucial role in assessing disease severity and localization. Treatment options include surgical intervention or resynchronization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, calcification can affect nearly every part of the heart, with diverse underlying reasons and etiologies such as rheumatic heart disease and congenital pulmonic valve disease. Both surgical and resynchronization methods are available for patient management. However, further research is necessary to enhance our understanding of the coconut LA (calcification of the LA).<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70282","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T10:30:39Z","timestamp":1756549839000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Coconut Left Atrium: Causes and Management"],"prefix":"10.1111","volume":"42","author":[{"given":"Gisou","family":"Erabi","sequence":"first","affiliation":[{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarmad","family":"Karimi","sequence":"additional","affiliation":[{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assal","family":"Behkar","sequence":"additional","affiliation":[{"name":"Student Research Committee Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diba","family":"Allafi","sequence":"additional","affiliation":[{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyhaneh","family":"Shahveghar","sequence":"additional","affiliation":[{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araz","family":"Pooryai","sequence":"additional","affiliation":[{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir","family":"Najafabadian","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Science and Research Branch Islamic Azad University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-5956","authenticated-orcid":false,"given":"Shayan","family":"Mirshafiee","sequence":"additional","affiliation":[{"name":"Department of Cardiology School of Medicine Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4486-9683","authenticated-orcid":false,"given":"Mohaddeseh","family":"Behjati","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Research Center Cardiovascular Research Institute Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2014.10.004"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.05.085"},{"key":"e_1_2_5_4_1","first-page":"213","article-title":"Calcification and Osteogenic Change of the Left Auricle in a Case of Auricular Fibrillation","volume":"12","author":"Oppenheimer B.","year":"1912","journal-title":"Proceedings of the New York Pathological Society"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00583-7"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/60.4.559"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(06)70909-6"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.01.011"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytab320"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-003-0854-2"},{"issue":"10","key":"e_1_2_5_11_1","article-title":"A Case of Multiple Calcific Embolic Strokes in a Patient With a Porcelain Left Atrium","volume":"13","author":"Karan A.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/501396"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.04.305"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.163.6.7992726"},{"issue":"2","key":"e_1_2_5_15_1","first-page":"202","article-title":"Left Atrial Calcification in Rheumatic Heart Disease","volume":"11","author":"BS E.","year":"1949","journal-title":"American Journal of Roentgenology and Radium Therapy"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.892449"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.8979-21"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.55.6125"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.032698"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.03.078"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy245"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2019.07.011"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000058168.26163.BC"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.04.018"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2946-23"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.108.799437"},{"issue":"6","key":"e_1_2_5_27_1","first-page":"431","article-title":"Atrial Fibrillation in Pure Rheumatic Mitral Valvular Disease Is Expression of an Atrial Histological Change","volume":"13","author":"Alessandri N.","year":"2009","journal-title":"European Review for Medical & Pharmacological Sciences"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.09.089"},{"issue":"1","key":"e_1_2_5_29_1","first-page":"49","article-title":"Coconut Atrium: Transmural Calcification of the Entire Left Atrium","volume":"27","author":"Del Campo C.","year":"2000","journal-title":"Texas Heart Institute Journal"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00101-5"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.22468\/cvia.2024.00080"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.100.2.307"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-233115"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:35:08Z","timestamp":1758641708000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,30]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/echo.70282"],"URL":"https:\/\/doi.org\/10.1111\/echo.70282","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,30]]},"assertion":[{"value":"2025-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70282"}}