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Idiopathic 'True' Left Ventricular Aneurysm

Thorsten M Leucker1, Vineet Agrawal2, Hussein Rahim2

  • 1Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA.

Journal of Cardiology Cases
|December 15, 2015
PubMed

Insights

A 67-year-old patient

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac Surgery

Background:

  • Left ventricular aneurysm (LVA) can present with diverse etiologies.
  • Differentiating between ischemic and non-ischemic causes is crucial for management.
  • Idiopathic LVA is a rare diagnosis requiring exclusion of other causes.

Purpose of the Study:

  • To present a case of left ventricular aneurysm (LVA).
  • To investigate the etiology of the LVA in a patient with anginal symptoms.
  • To highlight the diagnostic process for identifying an idiopathic LVA.

Main Methods:

  • Computed tomographic angiography (CTA) for initial assessment.
  • Contrast echocardiography (TTE) and cardiovascular magnetic resonance imaging (CMR) for detailed cardiac evaluation.
  • Coronary angiography and surgical findings to determine etiology.

Main Results:

  • CTA revealed a left ventricular apical outpouching.
  • TTE and CMR suggested a true left ventricular aneurysm (LVA).
  • Absence of coronary artery disease and late enhancement on CMR pointed to a non-ischemic origin, ultimately diagnosed as idiopathic LVA.

Conclusions:

  • This case underscores the importance of a comprehensive diagnostic approach for LVA.
  • Excluding common causes like ischemic heart disease, iatrogenic, and congenital factors is key.
  • Idiopathic LVA, though rare, should be considered when other etiologies are ruled out.

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