Left Ventricular Aneurysm with Normal Coronary Angiogram

A Case Report and Literature Review

Kao, Pai-Feng
Hung, Wen Yueh
Ko, Wen-Chin
Yang, Hung-Yu
Chan, Paul

¹Division of Cardiology, Taipei Medical University-Wan Fang Hospital, and ²Division of Cardiology, Cathay General Hospital, Taipei, Taiwan.

Received: July 29, 2004 Accepted: November 17, 2004

Address correspondence and reprint requests to: Dr. Paul Chan, Division of Cardiovascular Medicine, Taipei Medical University-Wan Fang Hospital, 111, Sec. 3, Hsing-Lung Road, Wen-Shan District, Taipei City 116, Taiwan. Tel: 886-2-2930-7930 ext. 2817, 2816;

Fax: 886-2-2933-9378; E-mail: [email protected]

Acta Cardiologica Sinica 21(3):p 153-157, September 2005.

Most left ventricular aneurysms (LVA) develop in the atherosclerotic occlusive coronary artery disease following a transmural myocardial infarction. However, occasionally, LVA associated with normal coronary artery was found as well in dilated cardiomyopathy, hypertrophic cardiomyopathy, Chagas's disease, sarcoidosis, chest trauma, and congenital malformation. We report a 53-year-old male who had systolic heart failure owing to a posterior wall aneurysm of the left ventricle, which was found unintentionally during echocardiographic examination. Subsequent stress thallium scan revealed irreversible defects in the inferolateral wall and apex, and coronary angiography showed normal coronary arteries. The patient remained well under medical control for a follow-up period of 40 months. Previously undiagnosed inferoposterior wall myocardial infarction caused by thromboembolism with spontaneous reperfusion may be considered in this patient.