Submitral left ventricular aneurysm: Characteristics, diagnosis, management, and outcome

Abstract

Left ventricular (LV) aneurysm (LVA) is an uncommon cardiac disorder. There is no documented report from Ethiopia. Our objective was to discuss a case of LVA we encountered and analyze the clinical characteristics, diagnosis, management modalities, and outcome of patients with LVA from published studies over the last 200 years. in addition to the case we encountered, we searched PubMed for publications on patients with LVA and analyzed those reported since 1816. We identified 369 patients with LVA. The mean age at diagnosis was 31.7 ± 21.7 years, and 52.3% of them were males. It was more frequently reported from Africa (32.0%) and Europe (31.4%). The inferior part of the left ventricle including the submitral area is the most frequently (51.8%) reported location for LVA. Diagnosis was made coincidentally in most (40.1%) of the patients. The presenting features in those symptomatic patients were dyspnea or heart failure (HF) (23.8%), rhythm disturbances (18.2%), chest pain (10.6%), syncope (8.4%), thrombus (10.8%), or embolic events (5.4%). The universally used diagnostic modality was echocardiography. Electrocardiography (61%), chest X-ray (31.2%), cardiac catheterization (42.8%), computed tomography (1.3%), and magnetic resonance imaging (1.6%) were used as confirmatory or complementary imaging tests. During the follow-up period, death from cardiac causes occurred in 13.1% of the patients, with the leading cause of the cardiac death being congestive HF (51.9%). LVA has varied clinical features with potentially deleterious outcomes. While close follow-up with echocardiography in such patients is necessary, building the local expertise in surgical management of such patients is recommended as it has implications on individual patient, proper health-care utilization, and health-care costs.

Keywords

• diagnosis
• management
• outcome
• submitral left ventricular aneurysm