Annular subvalvular idiopathic left ventricular aneurysms in the black African.

The case of a Black African patient with an annular subvalvular left ventricular aneurysm of unknown origin is described, and the pathological findings in this condition together with a review of the literature is presented. We have operated on 12 patients with this condition between 1958 and 1978. Ventricular aneurysm in the Black African is extremely rare; aneurysms resulting from ischemic heart disease have not been encountered in this racial group, and contrary to earlier reports in the literature, syphilis is not the most common cause of left ventricular aneurysms in this group. The aneurysms arise in the fibrous rings below either the aortic or the mitral valve, extend around the valves in this situation, and may occur either singly or in both positions in the same heart. After various etiological factors are excluded, it is probable that in this group of patients the aneurysms develop initially as pulsion diverticula through a congenital weakness in the ventricular wall in the region of the atrioventricular groove.