What is the clinical evidence from this study?

Study design: Case Report. Population: Left ventricular aneurysm (n=1). Intervention: Optimized medical therapy and long-term anticoagulation. Primary outcome: Clinical stability and survival.

What does this research mean for the field?

Patients with giant left ventricular aneurysms can achieve multi-year clinical stability on optimized medical therapy and anticoagulation when surgery is declined or contraindicated. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the incidental diagnosis and successful long-term conservative management of a giant left ventricular aneurysm in a patient declining surgical reconstruction.

July 18, 2026JACC Case ReportsOpen Access

Long-Term Survival With Left Ventricular Aneurysm

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Key result

Medical therapy with anticoagulation maintains clinical stability over 2 years in giant LV aneurysm.

Why the study?

Incidental detection of left ventricular aneurysm on routine imaging remains uncommon and clinically challenging.

Population

One 58-year-old man with ischemic cardiomyopathy, HFrEF, and a giant inferolateral LVA

Design

Case report

Follow-up

2 years

Authors

UEUriel Encarnación-MartínezInstituto Nacional de Cardiología FAFernando Arriaga-PáezInstituto Nacional de Cardiología CGCarlos Alfredo Guillén-OrtizInstituto Nacional de Cardiología

Discussion

Member takes

Implication

May support medical therapy as fallback when surgery declined in giant LVA; hypothesis-generating, requiring prospective validation.

Key Points

To describe the incidental diagnosis and successful long-term conservative management of a giant left ventricular aneurysm in a patient declining surgical reconstruction.
Evaluated a 58-year-old man presenting with upper respiratory symptoms and an incidental round radiopacity along the cardiac silhouette on chest radiography.
Characterized the cardiac abnormality using point-of-care ultrasound, transthoracic echocardiography, and cardiac magnetic resonance imaging.
Managed the patient conservatively with guideline-directed medical therapy for heart failure with reduced ejection fraction and anticoagulation with rivaroxaban 20 mg once daily.
Cardiac magnetic resonance and echocardiography confirmed a giant inferolateral left ventricular aneurysm measuring 12.0 × 8.6 × 7.2 cm with transmural scar and a left ventricular ejection fraction of 28%.
Despite declining surgical ventricular reconstruction, the patient achieved sustained clinical stability across 2 years of optimized medical therapy and anticoagulation.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 58-year-old man with ischemic cardiomyopathy and heart failure with reduced ejection fraction who was incidentally found to have a giant left ventricular aneurysm and followed for 2 years.

Intervention

Optimized guideline-directed medical therapy (sacubitril/valsartan, bisoprolol, spironolactone, empagliflozin) and long-term anticoagulation (rivaroxaban 20 mg once daily).

Outcome

Clinical stability, including absence of hospitalizations, arrhythmic events, or thromboembolic complications.

Optimized medical therapy with long-term anticoagulation and close multidisciplinary follow-up can be a viable fallback strategy for patients with giant left ventricular aneurysms who decline or are ineligible for surgery.

Limitations

Single case report, limiting generalizability
Lack of randomized data for conservative management of giant left ventricular aneurysms

Cite This Study

Encarnación-Martínez et al. (2026) conducted a case report in Left ventricular aneurysm (n=1). Optimized medical therapy and long-term anticoagulation was evaluated on Clinical stability and survival. Optimized medical therapy with long-term anticoagulation provided sustained clinical stability over 2 years in a patient with a giant left ventricular aneurysm who declined surgery.

synapsesocial.com/papers/6a5b38f68167787360d24ddf https://doi.org/10.1016/j.jaccas.2026.108768

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Long-Term Survival With Left Ventricular Aneurysm

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Long-Term Survival With Left Ventricular Aneurysm

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

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