A prolonged severe cough, such as one lasting 30 years, is typically a symptom rather than a direct cause of right atrial enlargement in the heart. In cases of atrial enlargement, the underlying condition often leads to symptoms like coughing. A patient experiencing such symptoms should seek professional medical advice, ideally from a heart specialist. In this discussion, a user mentions their mother’s recent E.K.G. results indicating an enlarged right atrium, while her valve function and blood pressure are normal, and she shows no signs of shortness of breath or dizziness. A CT scan is planned for further evaluation. It is emphasized that any concerns or questions should be directed to her doctor for accurate assessment and guidance.