Large Submitral Aneurysm Compressing Left Main Coronary Artery: Rare Presentation of a Rare Disease

Submitral left ventricular aneurysm is a rare cardiac anomaly that was first reported from African countries and initially termed as "annular left ventricular aneurysm". Submitral aneurysm (SMA) causes out-pouching of the left ventricular wall, adjacent to the posterior leaflet of the mitral valve. Generally, SMA opens into left ventricle (LV) with a wide mouth and not into left atrium (LA). We report a case of Submitral Aneurysm with two openings: one into LV and the other into LA. This case also highlights the compression of coronary arteries by the submitral aneurysm. Large SMA can cause compression of left main coronary artery rarely. Having a knowledge of this point can help the clinician. SMA generally have an opening in LV but in this case SMA has two openings (One in LV and another in LA). This knowledge can help in proper surgical management.