Left Ventricular Aneurysm with Recurrent Ventricular Tachycardia

BACKGROUND: Ventricular tachyarrhythmias as complication of LV aneurysm are not unusual complication and can lead to sudden cardiac death. The accepted consensus for treatment of LV aneurism is medical therapy unless other indication for surgery exists, or existing treatment cannot control the symptoms. CASE REPORT: A 29-year-old man with no prior cardiac history was admitted to the hospital, after an episode of chest pain accompanied with fatigue and dizziness, for the last 2 h. His electrocardiogram on admission showed ventricular tachycardia with heart rate 260/min. Selective coronarography was performed and no significant stenosis of coronary artery was found. On transthoracic echocardiography, the left ventricle was mildly dilated (ejection fraction 50%), but whole apex was akinetic with giant aneurism. CONCLUSION: Aneurysms of the LV, sometimes associated with malignant ventricular arrhythmias, are very late complication of myocardial infarction. Resection of the aneurysm, although has no high-class recommendation (2), can cure the ventricular arrhythmias, as in presented case.