Background: Membranous interventricular septal aneurysm has been reported to accompany atrioventricular (AV) conduction defects. If it is accompanied by AV block, patients generally become symptomatic before the age of 40.
Case report: A 65-year-old male presented with presyncope and extreme fatigue for one week. Resting ECG showed a 2: 1 AV block. Transthoracic echocardiography revealed an interventricular septal aneurysm without any shunt. After making the diagnosis of type 2 second-degree AV block, a DDDR pacemaker was implanted.
Conclusions: We presented a 65-year-old male with new-onset presyncope. A diagnosis of septal aneurysm and associated AV block was made and a pacemaker was implanted.