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(Circulation. 1998;98:1698.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Submitral Aneurysm

Loizos Kontozis, MD; John Skoularigis, MD; Daniel Skudicky, MD; ; Pinhas Sareli, MD

From the Department of Cardiology, Baragwanath Hospital, University of Witwatersrand, Johannesburg, South Africa.

Correspondence to Loizos Kontozis, MD, Department of Cardiology, Baragwanath Hospital, PO Bertsahm 2013, Johannesburg, South Africa. E-mail psareli{at}iafrica.com

A 34-year-old black woman presented with a history of progressively worsening exertional dyspnea. Clinical examination revealed left heart failure and mitral regurgitation. Echocardiography showed a large, partially thrombosed submitral aneurysm arising immediately below the posterior mitral leaflet (Figure, left and center). Color Doppler flow imaging demonstrated systolic flow into the aneurysm and mitral regurgitation (right). The mechanism for the latter was interference of the aneurysm with posterior mitral leaflet function.

View larger version (35K): [in this window] [in a new window]   Figure 1. ANEUR indicates aneurysm; LA, left atrium; RA, right atrium; LV, left ventricle; RV, right ventricle; and AO, aorta. Unlabelled arrow points to neck of aneurysm.

Submitral aneurysms are a well-described entity among black Africans. They are thought to be false aneurysms caused by a congenital defect in the posterior portion of the mitral annulus and may produce symptoms through diastolic overload (by virtue of their volume or by causing mitral regurgitation), thromboembolism, arrhythmias, or compression of the left circumflex artery.

This patient had a successful surgical repair of the aneurysm and mitral valve repair.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.

This article has been cited by other articles:

				T. O. Cheng, D. Skudicky, and P. Sareli Submitral Aneurysm Is Not A False Aneurysm • Response Circulation, July 13, 1999; 100 (2): 211 - 214. [Full Text] [PDF]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kontozis, L. Articles by Sareli, P. Search for Related Content PubMed PubMed Citation Articles by Kontozis, L. Articles by Sareli, P.