Congenital muscular ventricular septal aneurysm coexisting with a pericardial cyst, a case report

Background Congenital muscular ventricular septal aneurysm (MuVSA) is an unusual type of congenital cardiac abnormality, the prognosis could be adverse due to impairment of the cardiac function. However, both the diagnosis and therapeutic strategy are challenging at present. Case presentation: A 32-year-old male patient was admitted for further assessment following occasional detection of a “left ventricular aneurysm” during a routine echocardiography. The patient did not have any discomfort, however, the echocardiography showed a left ventricular septal aneurysm accompanied by regional hypokinesis, enlargement of left ventricle complicated by reduced left ventricular ejection fraction (LVEF), about 46%. The coronary angiography excluded ischemic heart disease, the coronary computed tomography angiography and cardiac magnetic resonance showed the location of MuVSA and a cyst in the anteroinferior margin of the pericardium. Congenital MuVSA coexisting with pericardial cyst was then diagnosed. Pharmacological medications for heart failure were prescribed for the patient in order to prevent further deterioration of the heart function. At the 3-month follow-up the echocardiography showed the LVEF raised to 50% and the ventricular dimensions diminished. Conclusion Congenital MuVSA was very rare that might coexist with other congenital cardiac abnormalities, The prognosis could be adverse and the treatment for heart failure should be considered once evidence for deteriorated heart function was established.