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A 19-year-old male with a past medical history of a repaired ventricular septal defect (VSD) and cardiac arrhythmia presents with shortness of breath. He underwent VSD repair at 17 months and again at 5 years old. There is a questionable history of an aortic root aneurysm. The patient underwent a transthoracic echocardiogram revealing a normal ejection fraction without evidence of a VSD. An EKG-gated cardiac CT was ordered to evaluate the aortic root.The images demonstrate focal anterior outpouching of the membranous portion of the interventricular septum, into the right ventricle, just caudal to the right coronary cusp measuring 1.7 cm by 2.6 cm by 1.2 cm. which confirmed the diagnosis as aneurysm of the membranous interventricular septum. Differential diagnosis includes sinus of Valsalva an aneurysm, muscular ventricular septum aneurysm, membranous ventricular septal defect.
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