Ventricular tachycardia as a presentation of congenital left ventricular aneurysm

Left ventricular aneurysm (LVA) describes a region of ventricular wall that is thinner than the adjacent myocardial segments, balloons outward and exhibits either akinesis or dyskinesis. Congenital LVA is diagnosed by exclusion with a very low incidence, especially in adult patients with very few cases reported. Clinically, most congenital LVA are asymptomatic. The most common complaints are typical angina or atypical chest pain followed by syncope and heart rhythm disturbances. We describe the case of a 26-year-old-woman that presented with monomorphic sustained ventricular tachycardia as a first manifestation of congenital LVA. Successful endoventricular circular patch placement, or Dor procedure was performed. Successful substrate modification for arrhythmia development was performed and confirmed by an electrophysiological study. This would constitute the first case of this nature reported in Puerto Rico.