Submitral left ventricular aneurysm associated with thrombus

Abstract

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.

Keywords: Ethiopia, heart failure, submitral aneurysm, thrombus