Intraventricular muscle bundle as a novel cause of left ventricular aneurysm
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CASE REPORT
Open Access
Intraventricular muscle bundle as a novel cause of left ventricular aneurysm Junyu Pei1, Xiaoyan Zheng1, Yuting Liu2, Daoquan Peng1* and Bilian Yu1*
Abstract Background: There are a variety of causes of left ventricular aneurysm, but it is rarely due to a disturbance in intraventricular hemodynamics. To the best of our knowledge, there have been no reports of ventricular aneurysm at the left ventricular apex caused by an abnormal left ventricular muscle bundle. Case presentation: We report two cases of patients with congenital abnormal left ventricular muscle bundles which caused disturbances in intraventricular hemodynamics. This process eventually led to a left ventricular aneurysm at the apex of the heart. In both cases, transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) indicated ventricular aneurysm formation at the apex of the left ventricle. There were also abnormal muscular bundles connecting the ventricular septum and the posterior wall of the left ventricle. The only differences between these two cases were the comorbidities and severity of symptoms. Conclusion: Ventricular aneurysm at the apex of the left ventricle is common. However, it is rare for a ventricular aneurysm to form due to intraventricular hemodynamic disturbances caused by an abnormal muscle bundle as opposed to that due to original ventricular wall damage, which is more common. There is currently a lack of relevant studies on the treatment and prognosis of such patients. Whether surgical resection of a ventricular aneurysm leads to a better prognosis remains uncertain. Keywords: Left ventricular aneurysm, Abnormal left ventricular muscle bundle, Hemodynamics
Background Currently, the common definition of ventricular aneurysm adopted by most clinicians is any large area of left ventricle (LV) akinesia or dyskinesia that reduces the LV ejection fraction. Myocardial infarction (MI) is the most common cause of ventricular aneurysm; other underlying diseases include sarcoidosis, trauma, left coronary artery originating from the pulmonary artery, Chagas disease, or myocarditis [1]. Idiopathic left ventricular aneurysms that have no clear underlying cause are rare [2]. In addition, apical ventricular aneurysms caused by hypertrophic cardiomyopathy have gained recent attention [3]. In this * Correspondence: [email protected]; [email protected] 1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hu’nan, China Full list of author information is available at the end of the article
report, we introduce a previously undetermined potential cause of ventricular aneurysm.
Case prestation Case 1
A 67-year-old man developed chest tightness and recurrent cerebral infarction. No obvious cause of cerebral infarction was found in the local hospital, so the patient was subsequently referred to our hospital for further evaluation. The patient had no family history of heart disease. A physical examination demonstrate
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