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Updated: Aug 30, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Subepicardial aneurysm associated with ventricular septal perforation showing a normal coronary angiogram
Hirokazu Shiraishi1, Norifumi Urao, Masaki Tsukamoto
1Department of Cardiology, Kyoto Prefectural Yosanoumi Hospital, Yosa-gun, Japan.
Abstract:
Subepicardial aneurysm is a rare complication of acute myocardial infarction and the present case was associated with ventricular septal perforation. Echocardiography showed the subepicardial aneurysm adjoining the true apico-anteroseptal aneurysm, with the former being discontinuous with the myocardium at its neck, which was narrower than the diameter of the aneurysm. In addition, color Doppler imaging showed shunt flow from the aneurysm to the right ventricle. Coronary angiography revealed extension only of the anterior descending artery without any discernible stenosis. The apical aneurysm was excised and the defect closed with an epicardial patch. The myocardial infarction was probably caused by coronary spasm. Echocardiography was useful for diagnosing the anatomy and hemodynamic condition of the subepicardial aneurysm.
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