J Cardiovasc Ultrasound.  2016 Mar;24(1):68-70. 10.4250/jcu.2016.24.1.68.

Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State

• Gokhroo RK
• Anantharaj A
• Kishor K
• Ranwa B

• KMID: 2160999
• DOI: http://doi.org/10.4250/jcu.2016.24.1.68

Abstract

Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures.

Keyword

Submitral aneurysm; Congenital; Huge

MeSH Terms

Africa
Aneurysm*
Cardiac Output, Low*
Dyspnea
Humans
Male

Figure

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  Fig. 1 Two dimensional echocardiographic images acquired using Philips iE33/S5-1 probe. A: Apical 4 chamber view showing a large cystic mass of size comparable to both the ventricles put together. B: Same view with plane shifted anteriorly to visualize the communication (*) between the cyst and the left ventricle (just beneath the posterior mitral leaflet). C and D: Parasternal short axis view at the basal level (with and without color Doppler, respectively), showing the giant aneurysm compressing left ventricle, with bidirectional flow between the two, largest dimension of the aneurysm being 7.46 × 8.53 cm. AML: anterior mitral leaflet, PML: posterior mitral leaflet, PW: posterior wall of LV, IVS: inter ventricular septum, Ao: aorta, LV: left ventricle, RV: right ventricle.

• 

  Fig. 2 Left ventricular angiogram in right anterior oblique view with 30° angulation showing the giant aneurysm in free communication with the left ventricle at the basal level, its huge dimensions completely displacing the left ventricle from its original site. Pig tail catheter in situ seen.

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