BACKGROUND: Submitral left ventricular aneurysm is a rarely reported cardiac abnormality that is encountered commonly among blacks. So far, only one case has been reported from Ethiopia and East Africa.Our aim is to report an interesting and rare case that we encountered at St. Paul's Hospital Millennium Medical College. METHODS: In April 2017, a 25-year-old patient havingsubmitral left ventricular aneurysm with New York Heart Association (NYHA) class IV heart failure and mild left ventricular systolic dysfunctionreceived medical treatment at our institution. She had severe mitral regurgitation and aneurysmal thrombus. The diagnosis was easily made using GE Vivid E9 transthoracic echocardiography. She was given drugs for management of heart failure and anticoagulation. RESULTS:Our patient was discharged with a stable condition, and she had no early mortality. At 3 months' follow-up,shehad clinical improvement with NYHA class II heart failure, slight improvement of left ventricular systolic function, and resolution of the left ventricular thrombus. However, there waspersistent severe mitral regurgitation and aneurysm. CONCLUSION: Submitral left ventricular aneurysm is a rare cardiac abnormality. Diagnosis can be easily made with echocardiography. Surgery is the definitive treatment. However, it is not currently available in the country and patients cannot afford treatment abroad.

Red cell distribution width (RDW) is an indicator for the variability and size of circulating erythrocytes. Although some recent studies indicate that RDW can be used as a prognostic indicator in the management of patients with ST elevation myocardial infarction, several additional studies will be required to come on to agreement for its routine use. The study was an institution based observational cohort study that took place from May 1, 2013 to April 30 2014 at the First Affiliated Hospital of Zhengzhou University. Sixty patients with ST elevation myocardial infarction undergoing percutaneous coronary intervention were included in the study by convenient method. The Patients were divided in to two groups according to the RDW: 30(50%) patients with high RDW (range: ≥14%), and the rest 30(50%) patients with normal RDW (range: 11-13.9%). ST elevation Myocardial infarction is designated as an increase in troponin and CK-MB and ECG ST elevation. The demographic characteristics and parameters were included from patient records and severity of CAD was determined from angiography result. Complete blood count was done to measure level of red cell distribution width. Major adverse cardiac events (MACE) occur in 6 (20%) patients of High RDW group. High RDW is correlated with both higher MACE (r=0.333; p=0.009) as compared to patients with normal RDW. In Kaplan Meier analysis normal RDW patients had better survival than high RDW patients with higher GRACE score (r=0.293; p=0.024). Moreover absolute high RDW was correlated with both higher GRACE score (r=0.510; p=0.000) and with high MACE (r=0.427; p=0.001). Higher RDW at baseline was strongly correlated with Major adverse cardiac events both in the hospital and one month follow up. RDW should be routinely used as a baseline test in the management of patients with ST elevation myocardial infarction undergoing percutaneous coronary intervention.