Key result
Multimodality imaging characterizes a rare submitral LV aneurysm and thoracic mycotic aneurysm in TB lymphadenitis.
Why the study?
Submitral left ventricular aneurysm (SLVA) is rare and its incidence in Malays has never been documented; this is the first reported case of SLVA with concurrent thoracic aorta mycotic aneurysm in a Malay patient.
Case Report (n=1)
This case highlights the utility of multimodality imaging, particularly CMR, in diagnosing and characterizing rare submitral left ventricular aneurysms and concurrent mycotic aneurysms.
Answers are grounded in this paper and cite their sources.
May aid diagnosis of rare LV aneurysms with aortic involvement; leaves open need for prospective validation before wider use.
We present a case of a 20-year-old Malay man with underlying tuberculous (TB) lymphadenitis who presented with shortness of breath and found to have submitral left ventricular aneurysm (SLVA). SLVA is well recognised but rare. Incidence of SLVA in Malay has never been documented. This is the first reported case of SLVA in Malays with concomitant thoracic aorta mycotic aneurysm. TB has been reported to be associated with SLVA. Treatment is either surgical or conservative. Imaging is required for diagnosis and preoperative assessment. Multimodality imaging include echocardiography (ECHO), cardiac CTangiography and the robust multiparametric cardiac MR (CMR). ECHO is the first line imaging and useful for initial detection of the aneurysm. CMR including the late gadolinium enhancement allows excellent visualisation of the LV aneurysm, tissue characterisation, cardiac function and detection of associated pathology as shown in this case.
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Abdullah et al. (2017) conducted a case report in Submitral left ventricular aneurysm with concurrent descending aorta mycotic aneurysm (n=1). Multimodality cardiac imaging was evaluated. Multimodality cardiac imaging successfully characterized a rare submitral left ventricular aneurysm and concomitant thoracic aorta mycotic aneurysm in a 20-year-old man with TB lymphadenitis.
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