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Membranous ventricular septal aneurysm – incidental discovery or supstrate for atypical chest discomfort? Case report

Introduction: Aneurysm of membranous interventricular septum is a rare cardiac abnormality and the prevalence is not known. It can be isolated but is usually associated with congenital heart disease, most often with ventricular septal defect. Most patients are asymptomatic but special caution should be taken in considering potential risk.1, 2 Case report: 58-year-old female came because she had chest pressure with discomfort in back, fatigue and weakness. The blood pressure was 140/80 mmHg, heart rate 80 BPM and no heart murmur was discovered on clinical examination. Electrocardiography showed sinus rhythm, normal axis and right bundle branch block. The transthoracic echocardiogram discovered and the transesophageal exam confirmed the aneurysm of the membranous intraventricular septum without septal defects, pathological flows or intracavital masses. Conclusion: Aneurysm of membranous interventricular septum is occasional cardiac abnormality and the patients are often asymptomatic. Transthoracic echocardiography, transesophageal echocardiography, cardiac CT and MR imaging are the methods of choice for diagnosis of VSA aneurysm. Patients with VSA have risk of thrombus formation and stroke, ventricular tachycardia and AV block, aortic regurgitation, intracardiac shunts, ruptures and endocarditis.

membranous interventricular septum, ventricular septal defect, stroke

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