Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Nov 11:72:103042.
doi: 10.1016/j.amsu.2021.103042. eCollection 2021 Dec.

Submitral aneurysm: An unusual localization of aneurysm complicating a myocardial infarction: A case report

Saîda Amaqdouf  1 , Hammam Rasras  1 , Anas Hbali  1 , Soumia Boulouiz  1 , Nabila Ismaili  1   2 , Noha El Ouafi  1   2
Affiliations
Case Reports

Submitral aneurysm: An unusual localization of aneurysm complicating a myocardial infarction: A case report

Saîda Amaqdouf et al. Ann Med Surg (Lond). .

Abstract

Introduction: and importance: Submitral aneurysms are an uncommon heart condition that is widespread among young black Africans, congenital etiology is the most common, when SMA is found in patients of other races, other etiologies must be sought, especially ischemic.

Case presentation: We present the case of a 65-year-old male patient admitted for wide complex tachycardia at a rate of 198 bpm, in whom transthoracic echocardiography revealed a submitral aneurysm and coronary angiography revealed an occlusion of the left circumflex artery.

Clinical discussion: Submitral left ventricular aneurysm is a rare cardiac pathology with a variety of causes including inflammation, infection, traumatic illness, or, in rare cases, ischemic heart disease; it can be caused by a congenital defect in the posterior portion of the mitral annulus, which is more common in African population. Clinical manifestations are frequently serious and alarming, such as ventricular tachycardia, cardiogenic shock or an embolic phenomenon; however, asymptomatic cases are possible.

Conclusion: What we can retain from our case is that SMA can be the cause or consequence of coronary ischemia, so we must be vigilant in patients with an atypical clinical presentation.

Keywords: Aneurysm; Arrhythmia; Case report; Left ventricle; Pericardial effusion; Submitral; Thrombus.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
EKG showing a wide complex tachycardia at a rate of 198 bpm.
Fig. 2
Fig. 2
EKG after electric cardioversion.
Fig. 3
Fig. 3
TTE; A: apical four chamber showing the aneurysm (red arrow), the thrombus (blue arrow) and the pericardial effusion (white arrow). B: parasternal long axis view demonstrating the submitral aneurysm. LV: left ventricle, LA: left atrium. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
Fig. 4
Fig. 4
Coronary angiography: occlusion of the left circumflex artery. Cx: Left circumflex artery.
See this image and copyright information in PMC

References

    1. Ohlow M.A., von Korn H., Lauer B. Characteristics and outcome of congenital left ventricular aneurysm and diverticulum: analysis of 809 cases published since 1816. Int. J. Cardiol. 2015 Apr 15;185:34–45. doi: 10.1016/j.ijcard.2015.03.050. Epub 2015 Mar 5. PMID: 25782048. - DOI - PubMed
    1. Abrahams G.D., Barton C.J., Cockshott P.W., Edington G.M., Weaver E.J.M. Annular subvalvular left ventricular aneurysms. QJM: Int. J. Med. July 1962;31(Issue 3):345–360. doi: 10.1093/oxfordjournals.qjmed.a066973. - DOI - PubMed
    1. Ba'albaki H.A., Clements S.D., Jr. Left ventricular aneurysm: a review. Clin. Cardiol. 1989 Jan;12(1):5–13. doi: 10.1002/clc.4960120102. PMID: 2643491. - DOI - PubMed
    1. Zoffoli G., Mangino D., Venturini A., Terrini A., Asta A., Zanchettin C., Polesel E. Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature. J. Cardiothorac. Surg. 2009 Feb 24;4:11. doi: 10.1186/1749-8090-4-11. PMID: 19239694; PMCID: PMC2654444. - DOI - PMC - PubMed
    1. Du Toit H.J., Von Oppell U.O., Hewitson J., Lawrenson J., Davies J. Left ventricular sub-valvar mitral aneurysms. Interact. Cardiovasc. Thorac. Surg. 2003 Dec;2(4):547–551. doi: 10.1016/S1569-9293(03)00141-5. PMID: 17670119. - DOI - PubMed

Publication types