Congenital left ventricular aneurysm

Congenital left ventricular aneurysm (also known as congenital ventricular diverticulum or congenital cardiac aneurysm) is an extremely rare structural heart defect present at birth, characterized by an abnormal outpouching or bulging of the left ventricular wall. Unlike acquired ventricular aneurysms that develop after myocardial infarction in adults, this condition arises during embryonic cardiac development. The aneurysmal wall may be composed of thinned myocardium (muscular type) or fibrous tissue (fibrous type), and the defect can vary in size and location along the left ventricle. The condition primarily affects the cardiovascular system. Clinical presentation is highly variable, ranging from asymptomatic cases discovered incidentally on imaging to severe manifestations including heart failure, arrhythmias (abnormal heart rhythms), thromboembolic events (blood clots), and, in rare cases, rupture of the aneurysm. Some patients may present with systolic murmurs, chest pain, or signs of reduced cardiac output. Congenital left ventricular aneurysms may occur in isolation or in association with other congenital anomalies, including midline thoracoabdominal defects (Cantrell's pentalogy), septal defects, or other cardiac malformations. Diagnosis is typically made through echocardiography, cardiac MRI, or CT angiography. Management depends on the size of the aneurysm, associated symptoms, and risk of complications. Asymptomatic patients with small aneurysms may be monitored with regular imaging and clinical follow-up. Surgical repair or resection is generally recommended for large or symptomatic aneurysms, those at risk of rupture, or those associated with significant arrhythmias or thrombus formation. Anticoagulation therapy may be used to prevent thromboembolic complications. Long-term prognosis varies depending on the severity of the defect and the presence of associated anomalies.

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