Left ventricular aneurysm without coronary artery disease, incidence and clinical features: Clinical analysis of 11 cases

Objective To examine the incidence, underlying disease and clinical feature s of left ventricular aneurysm (LVA) not related to coronary artery occlusi on, Methods Retrospective review of consecutive patients who underwent both lef t ventriculography and coronary angiography, Patients LVA was confirmed in 11 of 2,348 consecutive patients (0.47 %), Results The location of LVA was mainly in the apical region (81.8 %), In fi ve of the 11 patients (45.5 %), the underlying heart disease was hypertroph ic cardiomyopathy (HCM), including 4 patients of dilated phase and one pati ent of midventricular type, The serial ECG changes from left ventricular hy pertrophy to abnormal Q wave and endomyocardial biopsy were useful for the differential diagnosis of these cases against myocardial infarction, The un derlying disease of the remaining patients was: myocarditis (2 patients), a rrhythmogenic right ventricular dysplasia (1 patient), Chagas' disease (1 p atient), glycogen storage disease (1 patient), and sarcoidosis (1 patient), Ventricular tachycardia appeared in 9 of 11. cases (81.8 %) including 2 pa tients with sustained ventricular tachycardia, Conclusion LVA formation without coronary artery disease was a rare phenome non. The underlying disease was varied but the incidence of hypertrophic ca rdiomyopathy in the dilated phase was comparatively high. Ventricular tachy cardia was a significant complication in these patients.