Heart transplantation for rapidly progressive dilated cardiomyopathy complicated by an inferolateral left ventricular aneurysm: a case report
- 1Department of Cardiology, Wuhan No. 1 Hospital
- 2Department of Cardiothoracic Surgery, The Affiliated Tianyou Hospital of Wuhan University of Science and Technology
Abstract
Background: Left ventricular (LV) aneurysm most commonly follows transmural myocardial infarction and is rarely described in dilated cardiomyopathy (DCM). When DCM and ischemic injury coexist, the presentation may be atypical and progression can be rapid.
Case summary: A 52-year-old man developed chest tightness and dyspnea after an upper respiratory tract infection. Echocardiography showed LV dilatation with reduced systolic function (LVEF 36%). Coronary angiography on hospital day 4 demonstrated severe stenoses of the left circumflex/obtuse marginal branch and a moderate right coronary artery lesion, and a drug-eluting stent was implanted in the left circumflex artery. One month later, he was readmitted with recurrent dyspnea, BNP 2,627 ng/L, complete left bundle branch block, marked LV dilatation (end-diastolic diameter 113 mm), severe functional mitral regurgitation, and a large inferolateral apical LV aneurysm (74 mm × 50 mm) with paradoxical motion. Despite intensified heart failure therapy, he progressed to end-stage heart failure and underwent heart transplantation. Histopathology of tissue adjacent to the aneurysm was consistent with myocardial infarction with chronic inflammatory cell infiltration, and the sampled left circumflex artery showed atherosclerotic stenosis.
Conclusion: In DCM with new regional wall motion abnormalities or rapid structural deterioration, concomitant ischemic injury should be considered even when symptoms are non-specific. Electrical and mechanical dyssynchrony may increase regional wall stress and contribute to aneurysm formation, accelerating clinical decline.
Related
- Long-term outcomes for repair of inferolateral left ventricular pseudoaneurysm via the endocardial exclusion patch technique
- Hypertrophic obstructive cardiomyopathy complicated by severe midventricular obstruction treated with percutaneous transluminal septal myocardial ablation using simultaneous contrast imaging with left ventriculography and coronary angiography: a case report
- Bilateral postpartum renal cortical necrosis complicated by peripartum cardiomyopathy after postpartum hemorrhage: a case report
- Transatrial air-assisted epicardial ventricular tachycardia ablation for hypertrophic cardiomyopathy and management of postprocedural right atrial thrombus.
- Recurrent Large‐Vessel Occlusive Stroke Requiring Repeated Mechanical Thrombectomy in Severe Dilated Cardiomyopathy With Extremely Low Left Ventricular Ejection Fraction and HIV Screening Positivity: A Case Report
BibTeX
@article{yu2026heart,
title = {{Heart transplantation for rapidly progressive dilated cardiomyopathy complicated by an inferolateral left ventricular aneurysm: a case report}},
author = {Zhihua Yu and Li Yang and Ye Xu and Zuomin Li and Lijun Wang and Liqun He},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1789290},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1789290/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Heart transplantation for rapidly progressive dilated cardiomyopathy complicated by an inferolateral left ventricular aneurysm: a case report
AU - Zhihua Yu
AU - Li Yang
AU - Ye Xu
AU - Zuomin Li
AU - Lijun Wang
AU - Liqun He
PY - 2026
DA - 2026/10/26
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1789290
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1789290/full
AB - Background: Left ventricular (LV) aneurysm most commonly follows transmural myocardial infarction and is rarely described in dilated cardiomyopathy (DCM). When DCM and ischemic injury coexist, the presentation may be atypical and progression can be rapid. Case summary: A 52-year-old man developed chest tightness and dyspnea after an upper respiratory tract infection. Echocardiography showed LV dilatation with reduced systolic function (LVEF 36%). Coronary angiography on hospital day 4 demonstrated severe stenoses of the left circumflex/obtuse marginal branch and a moderate right coronary artery lesion, and a drug-eluting stent was implanted in the left circumflex artery. One month later, he was readmitted with recurrent dyspnea, BNP 2,627 ng/L, complete left bundle branch block, marked LV dilatation (end-diastolic diameter 113 mm), severe functional mitral regurgitation, and a large inferolateral apical LV aneurysm (74 mm × 50 mm) with paradoxical motion. Despite intensified heart failure therapy, he progressed to end-stage heart failure and underwent heart transplantation. Histopathology of tissue adjacent to the aneurysm was consistent with myocardial infarction with chronic inflammatory cell infiltration, and the sampled left circumflex artery showed atherosclerotic stenosis. Conclusion: In DCM with new regional wall motion abnormalities or rapid structural deterioration, concomitant ischemic injury should be considered even when symptoms are non-specific. Electrical and mechanical dyssynchrony may increase regional wall stress and contribute to aneurysm formation, accelerating clinical decline.
SN - 2297-055X
ER -