Submitral Aneurysm: A Rare Cause of Severe Mitral Regurgitation

摘要

A 26-year-old male presented with history of progressively worsening dyspnoea for last six months and history of paroxysmal nocturnal dyspnoea and orthopnea for 3 days. There was no history of chest pain, palpitation, presyncope or syncope. There was no previous history suggestive of rheumatic fever. Besides this there was no history of any other chronic disease. On examination, his blood pressure was 110/70 mmHg and pulse rate was 126 beats/min and regular. His jugular venous pressure was raised with prominent ‘V’ wave and ‘Y’ descent. There was presence of bilateral pedal edema up to the level of ankle joint. On cardiovascular examination there was cardiomegaly with apex shifted downwards and outwards. Fist heart sound (S1) was soft, pulmonary component of second heart sound (P2) was loud and grade IV/VI pan systolic murmur was heard at apex and left sternal border. Chest auscultation revealed bilateral basal crepitations. Abdominal examination revealed tender hepatomegaly.