Left Ventricular Pseudoaneurysm

2000

Acta Medica Scandinavica, 1985

Echocardiographic findings in a patient with left ventricular pseudoaneurysm. Acta Med Scand 1985; 217: 319-23.

Journal of investigative medicine high impact case reports

Left ventricular pseudoaneurysm is a rare but life-threatening disorder that is frequently reported secondary to myocardial infarction or cardiac surgery. In this article, we chronicle the case of a patient with no prior risk factors who presented with a 2-week history of nonexertional atypical left chest pain. Apical 2-chamber transthoracic echocardiography revealed an unexpected outpouching of basal inferoseptal wall of the left ventricle, which had a narrow neck and relatively wide apex. The patient was diagnosed with left ventricular pseudoaneurysm and medical therapy was initiated. He refused to undergo the surgical intervention and subsequently, he was discharged from the hospital in stable condition. This article illustrates that physicians should be vigilant for atypical presentations of left ventricular pseudoaneurysm, and a high index of suspicion should be maintained for this stealth killer while performing appropriate diagnostic imaging. Additionally, we review the curre...

The International Journal of Cardiovascular Imaging, 2006

We present a case of a 55-year-old men who suffered a silent myocardial infarction four years earlier and presented with exertional dyspnoea. Cardiac magnetic resonance imaging (CMR) and Multislice computed tomography (MSCT) was performed and revealed a giant pseudoaneursym of the lateral wall of the left ventricle with the presence of a thrombus in the lateral wall of the pseudoaneursym. We present this case since excellent non-invasive evaluation of the pseudoaneursym was feasible using state-of-the-art imaging modalities. Information on left ventricular geometry and function as well as myocardial viability and coronary anatomy is available when both MSCT and CMR are performed. This combined approach of these two imaging modalities provide clinically relevant information and may guide therapeutic decision making.

Left ventricular pseudoaneurysms (LVP) are false aneurysms caused by the rupture of left ventricular wall as a complication of myocardial infarction, cardiac surgery, congenital heart disease, and, more rarely endocarditis. It is a rare condition that initiates 3-14 days are myocardial infarction affecting 0.5% of the patients. The known risk factors to develop LVP are age, history of hypertension, deficiency of collateral circulation after myocardial infarction, and female gender. The current case report describes LVP in a 58-year old male patient with frontal acute myocardial infarction history. The patient was diagnosed using ECG, CINE-MRI, DE-IR analysis, and thorax-CT followed by urgent cardiac surgery. The diagnosis was an apical pseudoaneurysm caused by previous myocardial necrosis. The Immunohistochemistry suggested cardiac fibrosis. The patient was discharged asymptomatic for angina pectoris, dyspnea and palpitations, and prescribed warfarin against clotting, β-blocker/vasodilator, furosemide diuretic, angiotensin receptor blocker, and proton pump inhibitor medication. After six months of follow-up, the patient demonstrated the absence of preoperative symptoms.

Journal of cardiovascular ultrasound, 2015

Medical Archives, 2014

Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata strophic complication of myocardial infarction, occurring in approximately 4% of pa tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm. The left ventricular pseudoaneurysm contains only pericardial and fibrous elements in its wall-no myocardial tissue. Because such aneurysms have a strong tendency to rupture, this disorder may lead to death if it is left surgically untreated. Case report: In this case report, we present a patient who underwent successful repair of a left ventricular pseudoaneurysm, which followed a myocardial infarction that was caused by occlusion of the left circumflex coronary artery. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients.

European heart journal cardiovascular Imaging, 2013

Heart, 1998

A 73 year old man developed a left ventricular pseudoaneurysm following acute myocardial infarction. Coronary angiography showed triple vessel disease with total occlusion of the right coronary artery. On left ventriculography, a serpentine-like pseudoaneurysm was demonstrated that originated from the posterobasal wall of the left ventricle and extended to the right ventricular free wall. He underwent coronary artery bypass surgery with no plication of the pseudoaneurysm. An organised thrombus was also found within the cavity of the pseudoaneurysm. He was doing well approximately eight months after the operation. The prognosis might be determined by the organised thrombus, the serpentinelike structure of pseudoaneurysm, the coronary revascularisation, and the vigorous medical management. (Heart 1998;80:94-97)

Echocardiography, 2005

Left ventricular pseudoaneurysm is a false aneurysm, which results from a left ventricle rupture contained by adherent pericardium or scar tissue. The most common etiology of left ventricular pseudoaneurysm is acute myocardial infarction but one-third of pseudoaneurysms develop following surgery. We present a case report of a patient who developed a false aneurysm of the left ventricle 2 months following surgical repair of a left ventricular aneurysm with a concomitant coronary bypass. (ECHOCARDIOGRAPHY, Volume 22, September 2005) left ventricular pseudoaneurysm, coronary artery bypass graft surgery (CABG)