Left ventricular aneurysm without coronary artery disease, incidence and clinical features: clinical analysis of 11 cases

Intern Med. 2000 Jul;39(7):531-6. doi: 10.2169/internalmedicine.39.531.

Abstract

Objective: To examine the incidence, underlying disease and clinical features of left ventricular aneurysm (LVA) not related to coronary artery occlusion.

Methods: Retrospective review of consecutive patients who underwent both left ventriculography and coronary angiography.

Patients: LVA was confirmed in 11 of 2,348 consecutive patients (0.47%).

Results: The location of LVA was mainly in the apical region (81.8%). In five of the 11 patients (45.5%), the underlying heart disease was hypertrophic cardiomyopathy (HCM), including 4 patients of dilated phase and one patient of midventricular type. The serial ECG changes from left ventricular hypertrophy to abnormal Q wave and endomyocardial biopsy were useful for the differential diagnosis of these cases against myocardial infarction. The underlying disease of the remaining patients was: myocarditis (2 patients), arrhythmogenic right ventricular dysplasia (1 patient), Chagas' disease (1 patient), glycogen storage disease (1 patient), and sarcoidosis (1 patient). Ventricular tachycardia appeared in 9 of 11 cases (81.8%) including 2 patients with sustained ventricular tachycardia.

Conclusion: LVA formation without coronary artery disease was a rare phenomenon. The underlying disease was varied but the incidence of hypertrophic cardiomyopathy in the dilated phase was comparatively high. Ventricular tachycardia was a significant complication in these patients.

MeSH terms

  • Adult
  • Aged
  • Arrhythmogenic Right Ventricular Dysplasia / complications
  • Cardiomyopathy, Hypertrophic / complications
  • Chagas Disease / complications
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Electrocardiography
  • Female
  • Glycogen Storage Disease / complications
  • Heart Aneurysm / diagnosis*
  • Heart Aneurysm / etiology
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Myocarditis / complications
  • Radionuclide Ventriculography
  • Retrospective Studies
  • Sarcoidosis / complications