Cardiac Pseudoaneurysm- A Death Defying Entity

Abstract

A pseudoaneurysm refers to a contained rupture of the myocardium with a tenuous pericardium walling off the leak. It needs to be differentiated from a true aneurysm by the fact that there is lack of myocardial tissue in the wall of a pseudoaneurysm. The differentiation between the two is pertinent as true aneurysms can be treated medically while pseudoaneurysms require urgent surgical treatment. Untreated pseudoaneurysms carry a high risk of rupture and mortality. We report a case of cardiac pseudoaneurysm developing in a 46-year-old male who had suffered myocardial infarction four months back. The patient now presented with chest pain and dyspnoea. CECT chest revealed a partially thrombosed large pseudoaneurysm arising from the posterior wall of left ventricle. While the clinical diagnosis of this entity is difficult, CECT plays a pivotal role in the non-invasive detection of pseudoaneurysms.

A Dual Atrioventricular Approach to Repair Pseudoaneurysm after Mitral Valve Surgery

“…Aside from these guidelines, studies have indicated that narrow neck LVPAs may spontaneously resolve and be treated medically with dual antiplatelet therapy, statins, β-blockers, and diuretics. 4 5 6 Therefore, medical management may be a viable option for patients with chronic small stable LVPAs or patients for which surgical intervention is too high risk. Surgical repair has a 23% mortality rate; however, the risk of rupture from untreated LVPAs is 30 to 45% and may be as high as 50% at 2 years, which often drives the decision to pursue surgical intervention.…”

Traumatic right ventricular rupture: Case report and brief review of the literature

“…In left ventricular (LV) ruptures with pseudoaneurysm, surgical repair is superior to conservative management [22 , 23] . Additionally, the risk of stroke from an untreated LV pseudoaneurysm poses a significant risk from the accumulating thrombus [24] .…”

Right atrial pseudoaneurysm complicating epithelioid hemangioendothelioma

“…On the other hand, a pseudoaneurysm is bounded only by the pericardium, and they should be managed aggressively as they have higher risks of rupture and hemodynamic compromise. [ 4 5 ]…”