Pseudoaneurysm of the left ventricle with moderate left-to-right shunt (original) (raw)
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International Journal of Cardiology, 2008
Postinfarction left ventricular pseudoaneurysms are rarely detected because the clinical manifestations are heterogeneous. Pseudoaneurysms are especially difficult to detect and manage in patients whose ischemic heart disease is concomitant with other conditions. Here we report a unique case of postinfarction pseudoaneurysm with left-to-right shunt in a patient with the triple vessel disease who also had end-stage renal failure and was treated with long-term hemodialysis. We discuss the clinical course, diagnosis and treatment of pseudoaneurysms and the association of this condition with left-to-right shunts.
Original Article, 2021
Introduction: Pseudoaneurysm may occur as a rare complication of myocardial infarction (MI) when a hemorrhagic process is covered by adherence of the visceral or parietal pericardium or of both, preventing the formation of cardiac tamponade. Pseudoaneurysm is prone to rupture because they are not easy to diagnose. Case presentation: Here, we report three cases of left ventricular pseudo-aneurysm (LVP) that all were related to MI. Two patients were managed conservatively, one of them was lost to follow-up, and the other one expired one month later. One patient underwent surgery, but he expired during post-operation period. Conclusions: High mortality rate of LVP emphasizes the importance of looking for it in cardiac evaluation of patients with history of MI. Due to available non-invasive modalities, the ability to differentiate LVP from other cardiac pathologies is improving. Still, the most recommended management of LVP is early surgery.
Cardiac Surgery and Follow-up Diagnosis of the Left Ventricular Pseudoaneurysm Patient
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.
Pseudoaneurysm originating from left ventricle aneurysm: An autopsy case and review of literature
Journal of Forensic and Legal Medicine, 2013
Rupture of the free wall of the left ventricle is a catastrophic complication of acute myocardial infarction. Rarely, free wall rupture is contained by overlying adherent pericardium, producing a pseudoaneurysm of the left ventricle. In this report, a case of a left ventricular pseudoaneurysm due to a previous myocardial infarction is described. A 55-year-old woman had a severe chest pain 11 months prior to death. No cardiac investigation was performed. Three days prior to death, she suffered from fatigue and weakness, and had a witnessed sudden cardiac death. At autopsy, a 8.5 x10 x 8 cm pseudoaneurysm of the left ventricle was found. There was severe coronary artery atherosclerosis. There were extensive adhesions between pericardium and pseudoaneurysm wall. The cause of death was attributed to heart failure and resulting arrhythmia. The case illustrates the rare event of left ventricular pseudoaneurysm first diagnosed at forensic autopsy.
Computed Tomography Features of Left Ventricular Pseudoaneurysm: A Case Report
Iranian Journal of Radiology, 2016
Left ventricular pseudoaneurysm is a rare and fatal complication of myocardial infarction. Patients usually die from hemorrhage; therefore, urgent surgical resection is the mainstay of treatment. The most important differential diagnosis for this entity is left ventricular true aneurysm that could be managed with medical treatment. The diagnostic work up of left ventricular abnormal outpouching is well illustrated in the literature; however, less is written about the role of computed tomography angiography (CTA). Hereby, we present a case of left ventricular pseudoaneurysm in a 65-year-old woman who suffered from an ST elevation myocardial infraction six months ago. The echocardiography and chest CTA examinations revealed formation of a large aneurysmal cavity posterolateral to the left ventricle with significant thrombus formation. However, less is written about the role of computed tomography angiography in the diagnostic work up of left ventricular pseudoaneurysm. We present the typical features of left ventricular pseudoaneurysm depicted with CTA.
Chronic pseudoaneurysm of the left ventricle
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 aneurysm and differential diagnosis with pseudoaneurysm]
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2012
Left ventricular aneurysm and pseudoaneurysm are two complications of myocardial infarction in which the role of imaging is paramount. The authors describe a case of a true aneurysm of the posterior wall, for which cardiac magnetic resonance was useful, although only intra-operative assessment confirmed the diagnosis.