Ruptured left ventricular subvalvar mitral aneurysm into the left atrium and left ventricle to left atrium fistula: case report of two pathological entities

Subvalvar mitral aneurysm is a rare entity that mostly occurs in the African population. We present a case of a 23-year-old male patient who presented with shortness of breath and atypical chest pain. On preoperative transthoracic echocardiography, a subvalvar mitral aneurysm was noted with severe regurgitation from the aneurysm opening into the left atrium. The surgical findings revealed a single aneurysm neck present in the posterior mitral valve annulus. In addition to and separate from the aneurysm, a left ventricular to left atrial fistula was present.