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Membranous Ventricular Septal Aneurysm

  Case radiograph

Contributor: Philip Stockwell, MD

Other imaging & studies

Angiogram Echo 4C

Patient presentation:

An 86 year old female with a history of hypercholesterol- emia, hypertension and peripheral vascular disease developed dizziness, dyspnea and mild chest pain. She was brought to the emergency department of an outlying hospital and was diagnosed with supraventricular tachycardia. After receiving intravenous diltiazem, she converted to normal sinus rhythm and had no further dyspnea or chest pain. She was admitted to the hospital for observation and cardiac enzymes were noted to be elevated (troponin I=5.4). She was transferred to hospital for cardiac catheterization.   Clinical course...

Aneurysms of the membranous septum without residual shunt may represent the natural history of spontaneously closing VSD's of childhood. Generally spontaneous closure of membranous VSD's, if it occurs, will be complete by age 10 and frequently leaves no residual deformity. Discovery of these silent aneurysms may be incidental to routine echocardiography. Antibiotic prophylaxis is not recommended.

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