Amaqdouf Saîda, Rasras Hammam, Hbali Anas, Boulouiz Soumia, Ismaili Nabila, El Ouafi Noha
Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco.
Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Morocco.
Ann Med Surg (Lond). 2021 Nov 11;72:103042. doi: 10.1016/j.amsu.2021.103042. eCollection 2021 Dec.
and importance: Submitral aneurysms are an uncommon heart condition that is widespread among young black Africans, congenital etiology is the most common, when SMA is found in patients of other races, other etiologies must be sought, especially ischemic.
We present the case of a 65-year-old male patient admitted for wide complex tachycardia at a rate of 198 bpm, in whom transthoracic echocardiography revealed a submitral aneurysm and coronary angiography revealed an occlusion of the left circumflex artery.
Submitral left ventricular aneurysm is a rare cardiac pathology with a variety of causes including inflammation, infection, traumatic illness, or, in rare cases, ischemic heart disease; it can be caused by a congenital defect in the posterior portion of the mitral annulus, which is more common in African population. Clinical manifestations are frequently serious and alarming, such as ventricular tachycardia, cardiogenic shock or an embolic phenomenon; however, asymptomatic cases are possible.
What we can retain from our case is that SMA can be the cause or consequence of coronary ischemia, so we must be vigilant in patients with an atypical clinical presentation.
及重要性：二尖瓣下动脉瘤是一种在年轻非洲黑人中较为常见的罕见心脏疾病，先天性病因最为常见，当在其他种族患者中发现二尖瓣下动脉瘤时，必须寻找其他病因，尤其是缺血性病因。
我们报告一例65岁男性患者，因宽QRS波心动过速入院，心率为198次/分，经胸超声心动图显示二尖瓣下动脉瘤，冠状动脉造影显示左旋支动脉闭塞。
二尖瓣下左心室动脉瘤是一种罕见的心脏病理状况，病因多样，包括炎症、感染、创伤性疾病，或在罕见情况下由缺血性心脏病引起；它可能由二尖瓣环后部的先天性缺陷导致，这在非洲人群中更为常见。临床表现通常较为严重且令人担忧，如室性心动过速、心源性休克或栓塞现象；然而，无症状病例也是可能的。
从我们的病例中可以得出，二尖瓣下动脉瘤可能是冠状动脉缺血的原因或后果，因此对于临床表现不典型的患者我们必须保持警惕。
