Left ventricular pseudoaneurysm as a complication of myocardial infarction

Background: According to the World Health Organization, cardiovascular disease is the number one cause of death globally, claiming millions of lives each year with an increasing prevalence. Myocardial infarction (MI) makes up a large sum of these deaths each year. While MI in itself is lethal, there are several complications that can increase the morbidity and mortality of an MI, such as left ventricular wall rupture and aneurysms. Case Presentation: We present a case of an elderly male with an extensive cardiac history who presented with a non-ST segment myocardial infarction (NSTEMI) managed with percutaneous coronary intervention. Hours after, he became hemodynamically unable and was found to have a pseudoaneurysm of the left ventricle. Despite aggressive efforts, his pseudoaneurysm ruptured and he ultimately succumbed to his condition. Conclusions: Left ventricular pseudoaneurysm is usually seen after myocardial infarctions with a rupture rate of up to 45% leading to a mortality rate of about 50%. While cardiac catheterization with left ventriculography is the gold standard for diagnosis, echocardiography can also be used as an alternative. Treatment is emergent cardiac surgery but still holds a high operative risk. Therefore, patients may be medically stabilized and managed prior to ultimate surgical intervention.

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Massive Left Ventricular Pseudoaneurysm 20 Years After Acute Myocardial Infarction

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.06.068 ◽

2013 ◽

Vol 62 (23) ◽

pp. e523 ◽

Cited By ~ 3

Author(s):

Domenico G. Della Rocca ◽

Giovanni B. Forleo ◽

Carlo A. Stazi ◽

Gianluca Franco ◽

Gianmarco A. Volpe ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Left Ventricular ◽

Left Ventricular Pseudoaneurysm

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An Asymptomatic Left Ventricular Pseudoaneurysm found incidentally at 12 months post Myocardial Infarction: Case Report and Review of the Literature

International Cardiovascular Forum Journal ◽

10.17987/icfj.v20i0.697 ◽

2020 ◽

Vol 20 ◽

Author(s):

Christian Brooks ◽

Heather Cooke

Keyword(s):

Myocardial Infarction ◽

Surgical Repair ◽

Left Ventricular ◽

Mechanical Complication ◽

Review Of The Literature ◽

Limited Data ◽

Left Ventricular Pseudoaneurysm ◽

History Of ◽

Multi Disciplinary Team

Highlights: Left ventricular pseudoaneurysms are a rare mechanical complication of myocardial infarction. If found acutely following infarction (within 2 weeks, with some advocating up to 3 months), surgical repair is recommended due to their high risk of rupture.Whilst associated with chest pain, dyspnoea and heart failure, some individuals are asymptomatic, with the diagnosis made incidentally on routine follow-up often months to years post infarction. Less is known about the natural history of these chronic pseudoaneurysms, with concerns around their propensity to rupture perhaps less than the mortality risk of surgical repair.We present the case of a 70 year-old asymptomatic man who was found to have a 1.6cm left ventricular pseudoaneurysm found incidentally on routine transthoracic echocardiogram. at 12-months post posterior myocardial infarctionThe consensus opinion of our institution's multi-disciplinary team regarding further management of this patient, with reference to the current limited data on chronic pseudoaneurysms, will be discussed.

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