Aneurysm of the inferobasal wall and ventricular septal rupture complicated with inferior myocardial infarction

Lee, Eun Ah; Ha, Tae In; Chung, Sang Ryul; Moon, Sung Soo; Lee, Soo Hyoung; Hong, Hyun Jin; Kim, Su Hyoung

Abstract

The incidence of left ventricular aneurysm following acute myocardial infarction is 5 to 10 percent. Eighty % of aneurysms involve the anteroapical wall of the left ventricle: They are four times more frequent in this wall than in the inferior or posterior wall. Anterior myocardial infarction causes aneurysm in the anteroapical wall of the left ventricle, while inferior myocardial infarction causes aneurysm in the posterobasal wall of the left ventricle. Yet the aneurysmal complications in the interventricular septum after myocardial infarction are very rare. A 74-year-old woman with inferior myocardial infarction presented with both an aneurysm of the inferobasal wall and a ventricular septal rupture, and these were detected by two-dimensional and Doppler echocardiography. The aneurysm originated from the inferobasal portion of the left ventricular wall. The short-axis view of the two-dimensional echocardiography revealed an abrupt discontinuity of the junctional area of the inferoseptum and the inferior segment, and a large aneurysm at the inferior portion of the left ventricular cavity. The communication orifice was 4 cm wide. Color Doppler echocardiography showed a left-to-right shunt flow from the aneurysm to the right ventricle. We report here on a case of an aneurysm of the inferobasal wall and a ventricular septal rupture, and these lesions were detected by two-dimensional and Doppler echocardiography.