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

Abstract

Background Right ventricular pseudoaneurysm is an extremely rare finding than left ventricular pseudoaneurysm, associated with high mortality. The diagnosis of right ventricle pseudoaneurysm is often challenging because of its rarity and lack of typical clinical features. However, advanced cardiac imaging techniques including CT angiogram and MRI can help a timely diagnosis to avoid a fatal outcome. Case presentation The authors present the imaging findings of a right ventricular pseudoaneurysm in a 33-year-old male, presented with dyspnea and chest pain after exertion for 2 weeks. The gated CT and cardiac MRI showed a small outpouching from the right ventricle apex into the pericardial space, consistent with a pseudoaneurysm. He underwent cardiac surgery and pseudoaneurysm resection with a favorable outcome. Conclusion Right ventricular pseudoaneurysm is a very rare complication following right heart catheterization and a potentially life-threatening condition that requires prompt diagnosis and management. Though the lack of its typical clinical presentation is often a diagnostic challenge, advanced cardiac imaging techniques including CT angiogram and MRI may help a timely diagnosis to avoid a fatal outcome.

Right ventricular pseudoaneurysm after pericardiocentesis: A rare image

“…Right ventricular pseudoaneurysm is a rare and potentially fatal condition [1,2]. Ventricular pseudoaneurysm is a contained rupture of the ventricular wall that may occur due to cardiac surgery, infective endocarditis, myocardial ischemia, syphilis, after penetrating chest trauma, endomyocardial biopsy, central venous or pulmonary artery catheterization, and transcatheter valve replacement [1][2][3][4].…”

“…A cardiac pseudoaneurysm differs from a true aneurysm by its wall which does not contain myocardial tissue and connects to the ventricle by a narrow neck. Thus, ventricular pseudoaneurysm is prone to fatal rupture and subsequent high mortality [3].…”

“…The diagnosis of RV pseudoaneurysm is often a challenge because of its rarity and lack of typical clinical features [3]. Most patients present with chest pain and dyspnoea; however, up to 10% can be asymptomatic [2].…”

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

“…A pseudoaneurysm of the RV myocardium is extremely rare, with very few cases reported in the literature. These reports of RV pseudoaneurysm have occurred in the setting of endomyocardial biopsy [10] , heart catheterization [11 , 12] , device-related complications [13] , blunt cardiac trauma [14 , 15] , and idiopathic [8 , 16 , 17] . Radiographically, the use of echocardiography, CTA, and cardiac MRI can be used to diagnosis, track progression, and guide management of RV pseudoaneurysms [14] .…”