Membranous ventricular septal aneurysm – incidental discovery or supstrate for atypical chest discomfort? Case report

    Authors

    Keywords

    membranous interventricular septum, ventricular septal defect, stroke

    DOI

    https://doi.org/10.15836/ccar2017.159

    Full Text

    **Introduction**: Aneurysm of membranous interventricular septum is a rare cardiac abnormality and the prevalence is not known. It can be isolated but is usually associated with congenital heart disease, most often with ventricular septal defect. Most patients are asymptomatic but special caution should be taken in considering potential risk. (1, 2) **Case report:** 58-year-old female is coming because she had chest pressure with discomfort in back, fatigue and weakness. The blood pressure was 140/80 mmHg, heart rate of 80 beats/min and no heart murmur were discovered by clinical examination. Electrocardiography showed sinus rhythm, normal axis and right bundle branch block. The transthoracic echocardiogram discovered and the transesophageal confirmed the aneurysm of the membranous intraventricular septum without septal defects, pathological flows or intracavital masses. **Conclusion:** Aneurysm of membranous interventricular septum is occasional cardiac abnormality and the patients are often asymptomatic. Transthoracic echocardiography, transesophageal echocardiography, CT and MR imaging are methods of choice for diagnosis of VSA aneurysm. Patients with VSA have risk of thrombus formation and stroke, ventricular tachycardia and AV block, aortic insufficiency, intracardiac shunts, ruptures and endocarditis.

    Literature

    1. Naidu A, Ricketts M, Goela A, Shoemaker G, Li S. Incidental discovery of a membranous ventricular septal aneurysm in two dissimilar patients. Case Rep Cardiol. 2012;2012:324326. https://doi.org/10.1155/2012/324326
    2. Carcano C, Kanne JP, Kirsch J. Interventricular membranous septal aneurysm: CT and MR manifestations. Insights Imaging. 2016 Feb;7(1):111–7. https://doi.org/10.1007/s13244-015-0456-3
    Cardiologia Croatica
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    Membranous ventricular septal aneurysm – incidental discovery or supstrate for atypical chest discomfort? Case report

    Extended Abstract
    Issue4
    Published
    Pages159
    PDF via DOIhttps://doi.org/10.15836/ccar2017.159
    membranous interventricular septum
    ventricular septal defect
    stroke

    Authors

    Rina Dalmatin*ORCIDPula General Hospital, Pula, Croatia
    Teodora Zaninović JurjevićORCIDUniversity Hospital Centre Rijeka, Rijeka, Croatia
    Luka ZaputovićORCIDUniversity Hospital Centre Rijeka, Rijeka, Croatia
    Alen RužićORCIDUniversity Hospital Centre Rijeka, Rijeka, Croatia

    *Correspondence email: rina.dalmatin@gmail.com

    Full Text

    Introduction: Aneurysm of membranous interventricular septum is a rare cardiac abnormality and the prevalence is not known. It can be isolated but is usually associated with congenital heart disease, most often with ventricular septal defect. Most patients are asymptomatic but special caution should be taken in considering potential risk. (1, 2)

    Case report: 58-year-old female is coming because she had chest pressure with discomfort in back, fatigue and weakness. The blood pressure was 140/80 mmHg, heart rate of 80 beats/min and no heart murmur were discovered by clinical examination. Electrocardiography showed sinus rhythm, normal axis and right bundle branch block. The transthoracic echocardiogram discovered and the transesophageal confirmed the aneurysm of the membranous intraventricular septum without septal defects, pathological flows or intracavital masses.

    Conclusion: Aneurysm of membranous interventricular septum is occasional cardiac abnormality and the patients are often asymptomatic. Transthoracic echocardiography, transesophageal echocardiography, CT and MR imaging are methods of choice for diagnosis of VSA aneurysm. Patients with VSA have risk of thrombus formation and stroke, ventricular tachycardia and AV block, aortic insufficiency, intracardiac shunts, ruptures and endocarditis.

    Literature

    1. 1.
      Naidu A, Ricketts M, Goela A, Shoemaker G, Li S. Incidental discovery of a membranous ventricular septal aneurysm in two dissimilar patients. Case Rep Cardiol. 2012;2012:324326.DOI
    2. 2.
      Carcano C, Kanne JP, Kirsch J. Interventricular membranous septal aneurysm: CT and MR manifestations. Insights Imaging. 2016 Feb;7(1):111–7.DOI