Left ventricular apical aneurysm in hypertrophic cardiomyopathy

Abstract

This case report presents 56-year-old woman after successful cardiopulmonary resuscitation for ventricular fibrillation. Diagnosis of anterior myocardial infarction with primary ventricular fibrillation was determined based on ECG and echocardiographic images. Coronary angiography, repeated detailed echocardiographic examination and magnetic resonance imaging, that were performed later, disclosed hypertrophic cardiomyopathy with apical aneurysm, which is less common for this diagnosis. Implantable cardioverter defibrillator (ICD) was implanted in secondary prevention of sudden cardiac death. We found several adequate ICD therapies in one year follow-up. The aim of this case report is to show that finding of left ventricular apical aneurysm does not necessarily mean old myocardial infarction based on coronary artery disease. It also alerts to increased risk of malignant arrhythmias as well as thromboembolic events.