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Submitral aneurysm in children: A rare entity with varied presentation!

ABSTRACT: We present echocardiographic images in two children with a diagnosis of submitral aneurysm. Both had absolutely different presentations. The diagnosis was established on echocardiography and no advanced imaging techniques were used.

SUBMITTER: Kumar V

PROVIDER: S-EPMC5067791 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Submitral aneurysm in children: A rare entity with varied presentation!

Kumar V V Saraf Rahul P RP Maiya S S SS Suresh P V PV

Indian heart journal 20160309

We present echocardiographic images in two children with a diagnosis of submitral aneurysm. Both had absolutely different presentations. The diagnosis was established on echocardiography and no advanced imaging techniques were used. ...[more]

PMID: 27751303

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Submitral aneurysm of varied aetiologies: a case series.

Project description:BackgroundSubmitral aneurysm is a rare disease initially described in the African population. It is usually considered congenital in origin, due to a defect in the posterior portion of the mitral annulus. However, it can be seen in other diseases like ischaemic heart disease, rheumatic heart disease, infective endocarditis, tuberculosis, and syphilis.Case presentationCase 1 was a 29-year-old female, hypertensive undergoing maintenance haemodialysis for chronic kidney disease and on anti-tubercular therapy. She was found to have a large submitral aneurysm with severe mitral regurgitation, moderate left ventricular dysfunction, and pericardial effusion on echocardiogram. Case 2 was a 58-year-old gentleman presented with inferior wall ST-elevation myocardial infarction and was thrombolyzed with streptokinase for the same. Echocardiogram done 6 months later for evaluation of dyspnoea showed a large inferobasal aneurysm. Case 3 was a 56-year-old hypertensive presented with dyspnoea on exertion and echocardiogram showed a large posterolateral region with transmural late gadolinium enhancement. Case 4 was a 13-year-old boy presented with fever and cerebrovascular accident. Echocardiogram revealed vegetation in the mitral valve and a small submitral aneurysm with vegetation inside it.DiscussionSubmitral aneurysm is usually considered congenital in origin. However, it can be due to ischaemic heart disease, rheumatic heart disease, Takayasu arteritis, and tuberculosis. Top dimensional echocardiogram is the investigation of choice. Cardiac magentic resonance imaging helps in identifying the underlying aetiology and delineating the surrounding structures.

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