Submitral Aneurysm in a Patient with a Normal Electrocardiogram
A ventricular aneurysm entails well-known risks for the patient such as heart failure, potentially lethal arrhythmias, and systemic embolic phenomena. The submitral or posterolateral ventricular aneurysm is a very rare variety, usually of congenital etiology, which may also have other causes, includ...
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2019-01-01
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Online Access: | http://dx.doi.org/10.1155/2019/7828909 |
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doaj-4581af4dd7a04637ad7efe5d259a20432020-11-24T20:51:29ZengHindawi LimitedCase Reports in Cardiology2090-64042090-64122019-01-01201910.1155/2019/78289097828909Submitral Aneurysm in a Patient with a Normal ElectrocardiogramCarlos A. Solis-Olivares0Irene Meester1Juan M. Solis-Soto2Instituto Mexicano del Seguro Social, Hospital General de Zona 67, Apodaca, Nuevo León 66600, MexicoUniversidad de Monterrey, Escuela de Medicina, San Pedro Garza Garcia 66238, MexicoUniversidad Autonoma de Nuevo Leon, Facultad de Odontologia, Monterrey 64460, MexicoA ventricular aneurysm entails well-known risks for the patient such as heart failure, potentially lethal arrhythmias, and systemic embolic phenomena. The submitral or posterolateral ventricular aneurysm is a very rare variety, usually of congenital etiology, which may also have other causes, including ischemic heart disease. The present case is about a 76-year-old male with the antecedent of an acute myocardial infarction 3 years ago. He presented with intermittent, brief, and self-limiting episodes of severe dyspnea, intense desperation, and accelerated palpitations, with a nonspecific electrocardiogram. An echocardiography revealed a large submitral aneurysm, with a good clinical response to the specific treatment of heart failure, antiarrhythmics, and oral anticoagulation therapy. We analyze the implications of an aneurysm in the context of an ischemic etiology, with special attention to the limitations of the electrocardiogram in the diagnosis of occlusions of the circumflex artery that irrigates the posterolateral region of the heart. We suspect that a greater number of patients with a culprit circumflex artery could receive appropriate coronary interventionism or thrombolysis if decision-making in the emergency room would not depend mainly on the electrocardiogram. Better stratification tools are needed to prevent late complications of infarction, such as those observed in this patient.http://dx.doi.org/10.1155/2019/7828909 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carlos A. Solis-Olivares Irene Meester Juan M. Solis-Soto |
spellingShingle |
Carlos A. Solis-Olivares Irene Meester Juan M. Solis-Soto Submitral Aneurysm in a Patient with a Normal Electrocardiogram Case Reports in Cardiology |
author_facet |
Carlos A. Solis-Olivares Irene Meester Juan M. Solis-Soto |
author_sort |
Carlos A. Solis-Olivares |
title |
Submitral Aneurysm in a Patient with a Normal Electrocardiogram |
title_short |
Submitral Aneurysm in a Patient with a Normal Electrocardiogram |
title_full |
Submitral Aneurysm in a Patient with a Normal Electrocardiogram |
title_fullStr |
Submitral Aneurysm in a Patient with a Normal Electrocardiogram |
title_full_unstemmed |
Submitral Aneurysm in a Patient with a Normal Electrocardiogram |
title_sort |
submitral aneurysm in a patient with a normal electrocardiogram |
publisher |
Hindawi Limited |
series |
Case Reports in Cardiology |
issn |
2090-6404 2090-6412 |
publishDate |
2019-01-01 |
description |
A ventricular aneurysm entails well-known risks for the patient such as heart failure, potentially lethal arrhythmias, and systemic embolic phenomena. The submitral or posterolateral ventricular aneurysm is a very rare variety, usually of congenital etiology, which may also have other causes, including ischemic heart disease. The present case is about a 76-year-old male with the antecedent of an acute myocardial infarction 3 years ago. He presented with intermittent, brief, and self-limiting episodes of severe dyspnea, intense desperation, and accelerated palpitations, with a nonspecific electrocardiogram. An echocardiography revealed a large submitral aneurysm, with a good clinical response to the specific treatment of heart failure, antiarrhythmics, and oral anticoagulation therapy. We analyze the implications of an aneurysm in the context of an ischemic etiology, with special attention to the limitations of the electrocardiogram in the diagnosis of occlusions of the circumflex artery that irrigates the posterolateral region of the heart. We suspect that a greater number of patients with a culprit circumflex artery could receive appropriate coronary interventionism or thrombolysis if decision-making in the emergency room would not depend mainly on the electrocardiogram. Better stratification tools are needed to prevent late complications of infarction, such as those observed in this patient. |
url |
http://dx.doi.org/10.1155/2019/7828909 |
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