Out of Africa

Abstract

The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

Submitral left ventricular aneurysm associated with thrombus

“…Clinical symptoms arise as a result of secondary mitral valvular regurgitation in most cases due to loss of leaflet coaptation or occasionally from compression of cardiac structures by the aneurysmal saccausing chest pain, or the patient can be asymptomatic for many years ( 3 ). Most cases present with symptoms and signs of acute or chronic heart failure and cardiogenic shock and less commonly with acute coronary symptoms, left ventricular thrombus, arrhythmias or systemic embolization ( 4 ). Our case presented with progressive symptoms of congestive heart failure, severe mitral regurgitation, and aneurysmal thrombus indicating advanced stage of disease.…”

“…The chest radiography findings are variable degrees of cardiomegaly with or without pulmonary congestion and calcified bulge on the left heart. Before the advent of echocardiography, cardiac catheterization and angio-ventriculography were necessary to characterize the aneurysm ( 4 ). Nowadays, echocardiography can effectively diagnose and characterize submitral aneurysm using its various modalities; 2D, 3D, color Doppler, contrast and transesophageal echocardiography.…”

“…Transthoracic echocardiography can clearly delineate aneurysmal dilatation in submitral location behind the posterior leaflet of the mitral valve, communicating with the left ventricular cavity through one or more necks ( 1 ). Current multi-detector cardiac CT and cardiac MRI studies have greatly improved the detailed description of a submitral aneurysm and detection of associated calcifications, thrombus formation and coronary artery compression ( 4 ). Our case had aneurysm behind the posterior mitral leaflet with a single neck and thrombus in the aneurysm and mildly depressed left ventricular systolic function.…”