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A 33-year-old woman who had previously undergone mitral valve repair for native valve endocarditis presented with a submitral left ventricular pseudoaneurysm, with related mitral valve dysfunction. The operative approach to this complex pathophysiologic process is presented.

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Background: Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by a large vessel vasculitis involving the aorta and its branches. Myocardial involvement is extremely unusual in TA and is mostly in the form of myocarditis, ventricular hypertrophy, and ventricular dysfunction secondary to coronary ischemia. Submitral aneurysms have been reported in TA and has been attributed to the chronic inflammatory process in TA.

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A sub-mitral left ventricular aneurysm is a rare condition. It is a congenital outpouching of the left ventricular wall, invariably occurring adjacent to the posterior mitral leaflet. Sub-mitral aneurysm (SMA) has usually been reported as a consequence of myocardial ischemia (MI), rheumatic heart disease, tuberculosis, and infective endocarditis.

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Submitral aneurysm is a rare type of non-ischaemic ventricular aneurysm. We describe the case of a 26-year-old woman with progressive dyspnoea for approximately 1 year who was diagnosed with a ruptured submitral aneurysm in the left atrium with severe regurgitation. The patient underwent aneurysm correction and mitral valve repair, and post-operative echocardiography showed no residual abnormalities.

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Submitral left ventricular aneurysm remains a rare condition with a varied etiology besides the congenital origin. We describe the case of a 62-year-old male patient who presented, two weeks after an inferobasal myocardial infarction (MI), with dyspnea and atypical chest pain. Transthoracic echocardiography (TTE) and cardiac computed tomography (CT) revealed a giant thin-walled submitral left ventricular aneurysm.

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