A large pseudoaneurysm of the left cardiac ventricle in a 57-year-old patient after urgent coronary artery bypass grafting and surgical mitral valve replacement due to acute myocardial infarction

Wieczorek, Joanna; Mizia-Stec, Katarzyna; Rybicka-Musialik, Anna; Janusiewicz, Piotr; Malinowski, Marcin; Deja, Marek

doi:10.5114/kitp.2014.47347

Cited by 2 publications

(6 citation statements)

References 8 publications

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“…LV pseudoaneurysm cases were reported infrequently in the literature, and it is clinically uncommon due to high risk of rupture, up to 45%, and subsequent remarkable mortality [ 9 ]. On our literature review, the most reported presentations were congestive heart failure (36%), chest pain (30%), and dyspnea (25%); while sudden death was noted in 3% of cases [ 6 , 7 , 8 , 12 , 13 , 14 ]. Myocardial infarction was the most common underlying etiology for LV pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…Left ventricular pseudoaneurysm can be also be caused by trauma, cardiac surgery, and infections [ 2 , 6 , 7 ]. However, myocardial infarction (MI) is still considered the most common cause for LV pseudoaneurysm [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, myocardial infarction (MI) is still considered the most common cause for LV pseudoaneurysm [ 7 , 8 ]. Clinical presentation may vary from anginal pain, symptomatic congestive heart failure, syncope, arrhythmia, cardiac rupture, tamponade and shock, to even asymptomatic in about 10–12% [ 2 , 6 , 7 , 8 ]. Diagnostic work up includes transthoracic/transesophageal echocardiography, magnetic resonance tomography, ventriculography, computed tomography, and radioisotope imaging [ 6 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical presentation may vary from anginal pain, symptomatic congestive heart failure, syncope, arrhythmia, cardiac rupture, tamponade and shock, to even asymptomatic in about 10–12% [ 2 , 6 , 7 , 8 ]. Diagnostic work up includes transthoracic/transesophageal echocardiography, magnetic resonance tomography, ventriculography, computed tomography, and radioisotope imaging [ 6 , 8 ]. While cardiac catheterization with left ventriculography is the gold standard for diagnosis, echocardiography is considered a great preliminary non-invasive diagnostic method for LV pseudoaneurysm [ 6 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnostic work up includes transthoracic/transesophageal echocardiography, magnetic resonance tomography, ventriculography, computed tomography, and radioisotope imaging [ 6 , 8 ]. While cardiac catheterization with left ventriculography is the gold standard for diagnosis, echocardiography is considered a great preliminary non-invasive diagnostic method for LV pseudoaneurysm [ 6 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Pseudoaneurysm Development after Free Wall Rupture Post Myocardial Infarction

Douedi

Alfraji

Upadhyaya

et al. 2020

JCDD

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Pseudoaneurysm Development after Free Wall Rupture Post Myocardial Infarction

Douedi

Alfraji

Upadhyaya

et al. 2020

JCDD

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Clinical characteristic and imaging findings of post-infarction left ventricular pseudoaneurysm versus aneurysm: a pooled analysis of 21,472 patients

Afshar

Tayebi

Samimisedeh

et al. 2023

Preprint

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Background Left ventricular pseudoaneurysm (LVPA) is a rare but life-threatening complication of myocardial infarction (MI). Given the similarities in the clinical presentations and the appearance of the cardiac imaging, differentiation of LVPA from left ventricular aneurysm (LVA) remains a challenge but is imperative for timely management. We summarized and compared clinical and imaging findings of post-MI LVPA and LVA. Method We performed a comprehensive search of the literature in PubMed and Scopus databases using combinations of key terms covering LVPA / LVA and MI. In both LVA and LVPA, individual-level patient data (IPD) and aggregated-level data (AD) studies were combined through a two-stage analysis method. Results We identified 379 eligible articles on LVPA (N= 504 patients) and 120 on LVA (n= 20,968). Based on our pooled analysis, cases were predominantly male in both groups (70.4%and 75.7 %, respectively), but LVPA patients were roughly older (Mean (95% Confidence interval (CI): (65.4 (62.4, 68.4) vs. 60.8 (58.9, 62.8) years, respectively) and had a shorter mean time interval from MI to diagnosis than LVA (5.1 vs. 27.8, months). At presentation, while 33.8 (95% CI: 22.1, 46.0) of patients with LVA had arrhythmia, only 1.0 % (95% CI: 0.0, 2.9) of LVPA patients presented with this symptom. LVPA compared to the LVA group, more frequently had ST-segment elevation (43.2% Vs. 28.6, respectively) but less frequently ECG signs of the old MI (42.2% Vs. 61.9, respectively). Echocardiography showed a lower diagnostic value in LVPA than LVA (Sensitivity: 81.4% Vs. 97.5%). Contrary to LVA, LVPA is mainly located on posterior and inferior segments based on echocardiography evaluations. On Cardiac MRI, the majority of LVPA patients had pericardial LGE (84.0% (CI 95%: 63.9, 95.5)). A higher percentage of LVPA compared to the LVA group dead during hospitalization (13.8% vs. 4.7%, respectively) or after discharge (17.5%vs. vs. 9.0%, respectively). Conclusion Arrhythmia is likely common in LVA patients at presentation but not in LVPA. LVPA is mainly located on the posterior and inferior, and LVA is on the anterior and apical segments. On cardiac MRI, pericardial LGE may suggest the presence of LVPA rather than LVA in suspected patients.

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A large pseudoaneurysm of the left cardiac ventricle in a 57-year-old patient after urgent coronary artery bypass grafting and surgical mitral valve replacement due to acute myocardial infarction

Cited by 2 publications

References 8 publications

Pseudoaneurysm Development after Free Wall Rupture Post Myocardial Infarction

Pseudoaneurysm Development after Free Wall Rupture Post Myocardial Infarction

Clinical characteristic and imaging findings of post-infarction left ventricular pseudoaneurysm versus aneurysm: a pooled analysis of 21,472 patients

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