Septal aneurysm and right ventricular obstruction: a case report.

A 32-year-old man with a history of ventricular septal defect presented with systolic and diastolic murmurs and vectocardiographic evidence of right ventricular hypertrophy. Echocardiography demonstrated a prominent systolic bulging of the interventricular septum into the right ventricle. Left ventricular angiograms indicated that the ultrasonic abnormality was based on an aneurysm of the membranous septum which produced a 35 mm Hg gradient within the right ventricle. After plication of this aneurysm, murmur and abnormal septal protrusion were not recorded.