Cor Vasa 2007, 49(10):369-372 | DOI: 10.33678/cor.2007.130

Left ventricular pseudoaneurysm as a complication of myocardial infarction

Daniela Černá¹, Josef Veselka¹, Ivan Vaněk², Kateřina Linhartová¹, Radka Duchoňová¹, Theodor Adla², Milan Horn³, Branislav Laca³

¹ Kardiovaskulární centrum pro dospělé - Kardiologické oddělení

² Oddělení kardiovaskulární chirurgie

³ Klinika zobrazovacích metod, Fakultní nemocnice Motol, Praha, Česká republika

Unlike true aneurysm, left ventricular pseudoaneurysm (PSA) as a complication of myocardial infarction occurs quite rarely. Its exact prevalence is not known, with data regarding the diagnosis, treatment and natural history of pseudoaneurysm obtained only from individual case reports. Judging by data available, the risk for rupture is high (30-45%), particularly within the first three months of a pseudoaneurysm developing. The most frequent causes of death in the long term are electromechanical dissociation and sudden death. Left ventricular PSA may be difficult to diagnose, especially because of its localization, occurring as it does most often in the inferior and posterior wall sections. Surgical resection appears to be the method of choice in the management of this condition in most patients.
We present the case report of a 75-year-old man with diabetes, presenting with generalized atherosclerosis, diagnosed to have asymptomatic inferolateral left ventricular PSA. The patient had had myocardial infarction 14 months before; coronary angiography did not document significant stenosis but a moderate aortic stenosis. The patient had successful surgical resection of the PSA and aortic valve replacement.

Keywords: Pseudoaneurysm; Left ventricle; Myocardial infarction; Echocardiography; Magnetic resonance imaging; Management by cardiac surgery

Published: October 1, 2007  Show citation