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 ::  Abstract
 ::  Introduction
 ::  Case report
 ::  Discussion
 ::  References
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CASE REPORT
Year : 1979  |  Volume : 25  |  Issue : 4  |  Page : 245-246

Aneurysm of membranous interventricular septum


Department of Cardiology,K.E.M Hospital,Parel,Bombay 400012., India

Correspondence Address:
Lilam S Shah
Department of Cardiology,K.E.M Hospital,Parel,Bombay 400012.
India
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Source of Support: None, Conflict of Interest: None


PMID: 529188

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 :: Abstract 

Echocardiographic features of an aneurysm of membranous in­terventricular septum are presented in a case of coarctation of aorta with membranous interventricular septal defect. The diagnosis was made by angiography.



How to cite this article:
Shah LS, Kulkarni D R, Vengsarkar A S. Aneurysm of membranous interventricular septum. J Postgrad Med 1979;25:245-6

How to cite this URL:
Shah LS, Kulkarni D R, Vengsarkar A S. Aneurysm of membranous interventricular septum. J Postgrad Med [serial online] 1979 [cited 2020 Oct 22];25:245-6. Available from: https://www.jpgmonline.com/text.asp?1979/25/4/245/42232



 :: Introduction Top


Formation of aneurysm in membra­nous interventricular septum has been reported. [2],[3],[4],[5],[7] Aneurysm of mem­branous septum is one of the mechanisms accounted for the spontaneous closure of the ventricular septal defect. Echocar­diographic recognition of the aneurysm of membranous interventricular septum is reported in this case.


 :: Case report Top


Rajesh Prasad, a 7 year old child presented with symptoms suggestive of respiratory tract infection. He was found to have a murmur since early childhood. Clinical examination revealed a pulse of 80/min., regular, with brisk upstroke. B.P. in upper limbs was 180/110 ram Hg. In the lower limbs, systolic B.P. was 110 mm Hg. whereas diastolic B.P. was not recordable. There was radiofemoral delay; there was no clubbing, or cyanosis and also no evidence of cardiac failure. Cardiovascular system examin­ation revealed mild right ventricular hyper­trophy, pansystolic murmur gr. 3/6 along the left sternal edge in 3-4th left intercostal space, pulmonary ejection systolic murmur and moderate accentuation of pulmonic component of the second heart sound. X-ray chest show­ed cardiomegaly, left ventricular hypertrophy and moderate increase in pulmonary vascula­rity. ECG revealed left ventricular hypertrophy with strain pattern. Cardiac catheterization showed step up in SaO 2 % at ventricular level suggesting left to right shunt at the ventricular level (Qp/Qs = 1.5:1). Left ventricular angio­graphy revealed opacification of ventricular outflow tract with an outpouching of the mem­branous septum (See [Figure 1A] on page 246A)­There was post ductal coarctation of aorta (See [Figure 1B] en page 246A). Ductus arteriosus was absent and pulmonary artery was opacified through membranous ventricular septal defect.

The patient was subjected to echocardio­graphic studies. Echoes from the aneurysm of membranous septum were obtained from posi­tions 2 and 3 (See [Figure 2] on page 246A). [Figure 3] (see on page 246A) shows echoes from the buldging of membranous septum in late systole. Systolic pressure difference between the two ventricles was responsible for the bulging of the aneurysm of membranous septum.


 :: Discussion Top


The technique of detection of echoes from aneurysm of membranous interven­tricular septum is described by Sapire et al [6] The timing of the appearance of these echoes from aneurysmal sac in relation to cardiac cycle varies though usually these are more prominent during systole. [1] Similar findings are obtained in our case. [Figure 3] shows echoes from aneu­rysm of membranous interventricular septum more prominent in late systole. These echoes seem to be originating from the base (membranous) of the septum in systole and protruded in right ventricu­lar out flow tract. Angiographic appear­ance of this aneurysmal bulge from mem­branous interventricular septum into the right ventricular out flow tract confirmed the origin of these echoes. It caused right ventricular out flow obstruction of a mild degree.



 
 :: References Top

1.Assad-Morell, J. L., Tajik, A. J. and Giuliani, E. R.: Aneurysm of membra­nous interventricular septum. Echocardio­graphic features. Mayo. Clini. Proc., 49: 164-171, 1974.  Back to cited text no. 1    
2.Cornell, S. H. and Durnin, R. D.: Aneu­rysm of the membranous interventricular septum. Radiology, 91: 915-920, 1968.  Back to cited text no. 2    
3.Edelstein, J. and Charmes, B. L.: Ven­tricular septal aneurysms. A report of 2 cases. Circulation, 32: 981-984, 1965.  Back to cited text no. 3    
4.Hamby, D. I., Raia, F. and Apaido, O.: Aneurysm of the pars membranacia. Re­port of three adult cases, and review of literature. Amer. Heart J., 79: 688-699, 1970.  Back to cited text no. 4    
5.Pombo, E., Pilapil, V. R. and Lehan, P. H.: Aneurysm of the membranous ventricular septum. Amer. Heart J., 79: 188-193, 1970.  Back to cited text no. 5    
6.Sapire, D. W. and Black, I. F. S.: Echo­cardiographic detection of aneurysms of the interventricular septum associated with the ventricular septal defect. Amer. J. Cardiol., 36: 797-801, 1975.  Back to cited text no. 6    
7.Tandon, R. and Edward, J. E.: Aneurysm like formation in relation to membranous ventricular septum. Circulation, 47: 1089­1097, 1973  Back to cited text no. 7    


    Figures

  [Figure 1A], [Figure 1B], [Figure 2], [Figure 3]



 

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Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
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