An Incidentally Detected Right Ventricular Pseudoaneurysm

Abstract

Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

Spontaneous Right Ventricular Pseudoaneurysms and Increased Arrhythmogenicity in a Mouse Model of Marfan Syndrome

“…We furthermore observed a lack of cardiomyocytes in the walls of both types of cardiac lesions. Based on these characteristics, the lesions can be classified as pseudoaneurysms of the RV free wall [ 34 , 35 , 36 ]. We hypothesize that the etiology of the RV pseudoaneurysms in the Fbn1 mgR/mgR mouse model can be assigned to the reduced ability of the remaining fibrillin-1 fibers to maintain strong structural connections between adjacent myocardial muscle lamellae.…”

“…Secondly, detecting small lesions in a trabeculated right ventricular wall with conventional imaging techniques is particularly challenging and will require dedicated high-resolution modalities. Thirdly, these lesions may have remained undetected so far because autopsies are not routinely performed on deceased MFS patients, combined with the fact that severe (cardiovascular) forms of MFS in humans are rare [ 34 , 35 , 36 ]. With this research we hope to increase awareness for this new myocardial manifestation of MFS, which could potentially lead to new data regarding the prevalence of this type of cardiac lesions in MFS patients and other MFS mouse models.…”

“…Similar to the variable presence of dilated cardiomyopathy in Fbn1 mgR/mgR mice, it is likely that this novel cardiac manifestation is dependent on genetic modifiers associated with the genetic background, possibly explaining why this phenotype has not been observed previously in another study using mouse models of MFS. Further research is also warranted to investigate whether these ventricular pseudoaneurysms in a MFS mouse model are prone to rupture or increase the risk of arrhythmias and thromboembolism, as is known in the human setting of ventricular pseudoaneurysms [ 34 , 35 ].…”

Right ventricular pseudoaneurysm in a young adult following right heart catheterization: a rare case report and review of the literature

“…A cardiac pseudoaneurysm differs from a true aneurysm because its wall does not contain myocardial tissues and connects to the ventricle by a small neck. Thus, ventricular pseudoaneurysm is prone to fatal rapture and subsequent high mortality [1,3]. Although left ventricular pseudoaneurysm is uncommon, right ventricular pseudoaneurysm is extremely rare [2,3].…”

“…Thus, ventricular pseudoaneurysm is prone to fatal rapture and subsequent high mortality [1,3]. Although left ventricular pseudoaneurysm is uncommon, right ventricular pseudoaneurysm is extremely rare [2,3]. Transthoracic echocardiogram, cardiac MRI, and CT angiography can help diagnosis and management [4].…”