Ventricular Septal Aneurysm Mimicking Right Ventricular Outflow Tract Mass in a Patient With Ventricular Septal Defect

Figures

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  Figure 1. Ventricular Septal Aneurysm (A) Apical 4-chamber view showing a perimembranous ventricular septal defect (green line) with ventricular septal aneurysm (red arrow). (B) Color Doppler image showing flow across the ventricular septal defect. (C) Parasternal short-axis view showing a ventricular septal aneurysm (red arrow) causing right ventricular outflow tract obstruction (green line). (D) Spectral continuous wave Doppler image showing a peak velocity of 4 m/s (red arrow) equating to a gradient of 64 mm Hg across the ventricular septal defect; ECG tracing in green. (E) Spectral continuous wave Doppler image showing peak velocity of 2.5 m/s (red arrow) across the right ventricular outflow tract; ECG tracing in green.

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  Figure 2. Right-Sided Heart Catheterization With Shunt Run This study shows step-up from the right atrium (RA) (69.5%) to the right ventricle (RV) (80.2%). CI = cardiac index; CO = cardiac output; IVC = inferior vena cava; LV = left ventricle; PA = pulmonary artery; PCWP = pulmonary capillary wedge pressure; PVR = pulmonary vascular resistance; SVC = superior vena cava.

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  Figure 3. Cardiac Magnetic Resonance Sagittal View With Late Gadolinium Enhancement Cardiac magnetic resonance shows rim enhancement with central clearing (red arrow).