Abstract

Introduction: Left atrial appendage aneurysm is an infrequent abnormality presenting as atrial tachyarrhythmia, progressive dyspnea, atypical chest pain, and systemic thromboembolism. Surgical excision is considered to prevent fatal complications, even in asymptomatic cases. The present study aimed to report a 20-year-old male who presented with sudden onset palpitation and dyspnea. Case Presentation: The case was really novel, because congenital left atrial appendage aneurysm was accompanied by dilated cardiomyopathy and Left Ventricular (LV) non-compaction. Electrocardiography (ECG) showed atrial fibrillation with Rapid Ventricular Response (RVR) secondary to a massive congenital left atrial appendage aneurysm. At first, left-sided weakness was diagnosed. In the next Computed Tomography (CT) scan performed in the hospital, right temporoparietal hypodensity was detected, which was in favor of right Middle Cerebral Artery (MCA) territory infarction that progressed with hemorrhagic transformation. Conclusion: The patient did not accept surgical treatment and was discharged with medical therapy (oral anticoagulants and antiarrhythmic medications). He was expired as a result of multiple strokes. © 2022, Iranian Cardiovascular Research Journal. All rights reserved.