Key result
Inferior phrenic artery collateral vascular event linked to apical ventricular aneurysm in rare case.
Case Report (n=1)
Highlights a rare case of a left ventricular apical aneurysm caused by a vascular event involving noncoronary collateral blood flow from the left inferior phrenic artery.
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Anomalous phrenic supply should be considered in nonischemic apical aneurysms; this case leaves prevalence and causality open.
An 87-year-old man presented with exertional dyspnea and was admitted due to congestive heart failure. Echocardiography and left ventriculography performed after his condition improved showed an aneurysm at the left ventricular apex. However, coronary angiography showed no significant lesions and an avascular field at the apex. Computed tomography angiography revealed that the enlarged left inferior phrenic artery reached the heart and nourished the apex wall where the aneurysm was present. Looking back retrospectively, he was previously hospitalized nine years ago for epigastric pain with elevated myocardial deviation enzymes and electrocardiographic changes but no coronary artery lesions. Moreover, abnormal vascularization had already been observed 13 years ago when the aneurysm did not exit. Considering these findings, we concluded that the ventricular aneurysm in this case was caused by a vascular event involving collateral circulation from outside the heart.
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Ryoetsu Yamanaka (2023) conducted a case report in Apical aneurysm and heart failure (n=1). Noncoronary collateral myocardial blood flow (NCCMBF) from the left inferior phrenic artery was evaluated on Apical aneurysm formation. A rare case demonstrated that an apical ventricular aneurysm can be caused by a vascular event involving noncoronary collateral blood flow originating from the inferior phrenic artery.
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