Congenital aneurysm of both left ventricle and left atrium

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Imaging

Background:

• Congenital left ventricular (LV) free wall submitral aneurysm and left atrial appendage aneurysm are individually rare cardiac malformations.
• Simultaneous occurrence of both lesions in a single patient is unprecedented in medical literature, suggesting a potential common etiology.

Observation:

• The case involved a fetus diagnosed with irregular heart rate and abnormal echocardiogram in the third trimester.
• The patient underwent emergent atrial appendage plication due to clot formation and experienced complications like ventricular ectopy and pseudoaneurysm.
• Long-term echocardiograms confirmed persistent LV aneurysm and maintained good LV function.

Findings:

• This is the first reported case of co-occurring congenital LV submitral aneurysm and left atrial appendage aneurysm.
• Potential in utero etiological factors, including maternal infections and antibiotic exposure, were considered.
• The clinical course involved significant complications necessitating surgical intervention and ongoing monitoring.

Implications:

• This case expands the understanding of rare cardiac anomalies and their potential co-occurrence.
• It underscores the importance of comprehensive fetal cardiac evaluation and long-term follow-up for congenital heart conditions.
• Further research into the etiology of these combined lesions may reveal shared developmental pathways or genetic predispositions.