Post Myocardial Infarction Submitral Aneurysm Causing Stroke in an Elderly Patient- A Rare Case Report

Left ventricular aneurysms are a frequent and serious complication following acute myocardial infarction and are most commonly located at the ventricular apex. The majority of these patients presents with severe mitral insufficiency, congestive heart failure, systemic embolism and sudden cardiac death. Giant aneurysms occurring in a submitral position between anterior and posterior papillary muscles on the lateral ventricular wall constitute a minor entity and those leaving the mitral apparatus intact are extremely rare. Herein, we report the case of a 70 years old male patient with a past history of inferior wall myocardial infarction 1 year back, now presented with right hemiparesis due to cardio-embolic stroke caused by thombus present in submitral left ventricular aneurysm. Despite the size of the aneurysm and its close relationship to the posterior mitral annulus the mitral apparatus was intact with a competent valve and normal left atrial size. To the best of our knowledge there are only few case reports in the literature where a patient develops large submitral LV aneurysm after myocardial infarction.