Thin-walled apical ventricular aneurysm associated with hypertrophic obstructive cardiomyopathy

History and admission findings: A 73-year-old patient presented for routine follow-up examination for pre-diagnosed hypertrophic obstructive cardiomyopathy (HOCM). The patient's, history included arterial hypertension and dyspnea on exertion. Interventions: Echocardiography revealed a large apical aneurysm, which had vastly increased. in size over the past six months. Further evaluation by cardiac magnetic resonance (NMR) imaging confirmed the aneurysm and. demonstrated a wall thickness of no more than 2mm. Treatment and course: Due to the rapid increase in size in addition to the extremely thin wall diameter the risk of spontaneous rupture was considered high and the patient was referred to surgical therapy. Echocardiographic and NMR-findings were confirmed intraoperatively. The aneurysm was resected and the postoperative progress was uneventful. Conclusion: Aneurysms of the apical left ventricle can result from an underlying HOCK In case of rapid increase of the aneurysm, aneurysmectomy should be performed.