Abstract
The sub-mitral annular aneurysm is a rare cardiac pathology. The etiologies are diverse, ranging from the congenital form to the idiopathic form, including the acquired form. The clinical case we report is that of a 27-year-old young man, with no particular history, admitted with a picture of global heart failure. A cardiac ultrasound diagnosed a ruptured mitral sub-annular aneurysm in the pericardium. The difficulty lies in the surgical management of this condition, due to the lack of an adequate cardiac surgery service in most of the countries in Africa south of the Sahara.
Highlights
Open Access forms and clinical presentations [1]
The basic pathology of these lesions has been described as a disjunction between the musculature of the left ventricle, the left atrial region and the mitral valve due to the complex disruption of embryogenesis [5]
We report the case of a ruptured mitral sub-annular aneurysm in the pericardium, diagnosed in the cardiology department of the Ignace Deen National Hospital (Conakry)
Summary
The patient was a 27-year-old man with no known cardiovascular history who was seen for chest pain and NYHA class III dyspnea. The ECG showed a regular sinus rhythm of 87 beats/minute with left ventricular hypertrophy (Sokolow index Sv1 + Rv5 = 65 mm) and a secondary repolarisation disorder (negative T waves in the left precordial region, inferior without necrosis Q wave) (Figure 1). The frontal chest radiograph showed cardiomegaly (ICT = 0.59), at the expense of the left ventricle (Figure 2). 12-Lead electrocardiogram showing left ventricular hypertrophy and negative T waves in II, III, aVF and V6. Showed moderate dilatation of the left heart chambers. The evolution was marked by the regression of the signs of cardiac failure after having benefited from a treatment based on a beta-blocker (bisoprolol 1.25 mg per day), a diuretic (furosemide 40 mg per day) and a conversion enzyme inhibitor (perindopril 5 mg per day).
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