Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2024; 16(6): 363-369
Published online Jun 26, 2024. doi: 10.4330/wjc.v16.i6.363
Massive inferior wall aneurysm presenting with ventricular tachycardia and refractory cardiomyopathy requiring multiple interventions: A case report
Anderson Anuforo, Jake Charlamb, Dan Draytsel, Mark Charlamb
Anderson Anuforo, Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, United States
Jake Charlamb, Dan Draytsel, College of Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, United States
Mark Charlamb, Division of Cardiology, SUNY Upstate Medical University, Syracuse, NY 13210, United States
Author contributions: Anuforo A conceptualized and designed the manuscript, performed extensive literature review, wrote the first draft of the paper, critically revised the manuscript, acquired, interpreted, and analyzed data, created the final draft of the manuscript; Charlamb J wrote the first draft of the introduction, critically revised the manuscript, supported the literature review; Draytsel D critically revised the manuscript, supported the literature review; Charlamb M conceptualized and designed the manuscript, critically revised the manuscript, and approved the final version for submission.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anderson Anuforo, MBBS, Doctor, Department of Medicine, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, United States. anderson.anuforo@gmail.com
Received: February 28, 2024
Revised: May 1, 2024
Accepted: May 22, 2024
Published online: June 26, 2024
Processing time: 117 Days and 18.4 Hours
Abstract
BACKGROUND

Inferior wall left ventricular aneurysms are rare, they develop after transmural myocardial infarction (MI) and may be associated with poorer prognosis. We present a unique case of a large aneurysm of the inferior wall complicated by ventricular tachycardia (VT) and requiring surgical resection and mitral valve replacement.

CASE SUMMARY

A 59-year-old male was admitted for VT one month after he had a delayed presentation for an inferior ST-segment elevation MI and was discovered to have a large true inferior wall aneurysm on echocardiography and confirmed on coronary computed tomography (CT) angiography. Due to the sustained VT, concern for aneurysm expansion, and persistent heart failure symptoms, the patient was referred for surgical resection of the aneurysm with patch repair, mitral valve replacement, and automated implantable cardioverter defibrillator insertion with significant improvement in functional and clinical status.

CONCLUSION

Inferior wall aneurysms are rare and require close monitoring to identify electrical or contractile sequelae. Coronary CT angiography can outline anatomic details and guide surgical intervention to ameliorate life-threatening complications and improve performance status.

Keywords: Inferior wall aneurysm; True aneurysm; Ventricular tachycardia; Electrophysiology; Structural interventional cardiology; Case report

Core Tip: This case report is intended to assist clinicians anticipate and recognize complications arising from true inferior wall aneurysms in a bid to expedite timely pharmacologic and surgical interventions. It will also help outline the role of multidisciplinary care in managing inferior wall aneurysm complications to improve quality of care and help provide guidance in utilizing different imaging modalities to evaluate ventricular aneurysms and help guide therapy.