Left Ventricular Pseudoaneurysm Complicating Inferior Myocardial Infarction: A Case Report

ABSTRACT

Acquired pseudoaneurysm of the left ventricle is a very rare disorder and mostly occurs after large transmural myocardial infarction (MI) with peak creatine phosphokinase-MB levels greater than 150 IU/mL. Patients developing left ventricular (LV) pseudoaneurysm usually present with angina or heart failure symptoms. Although different imaging modalities exist, coronary angiography is the gold standard for diagnosis. Surgery is the treatment of choice for LV pseudoaneurysms detected in the first months after MI. Here we report the case of a 74-year-old woman who presented with a relatively small inferior MI due to right coronary artery occlusion and complicated by LV pseudoaneurysm.

KEYWORDS

Left ventricular pseudoaneurysm - myocardial infarction - surgery

REFERENCES

• 1 Dachman A H, Spindola-Franco H, Solomon N. Left ventricular pseudoaneurysm. Its recognition and significance.  JAMA. 1981;  246 1951-1953
• 2 Csapo K, Voith L, Szuk T, Edes I, Kereiakes D J. Postinfarction left ventricular pseudoaneurysm.  Clin Cardiol. 1997;  20 898-903
• 3 Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm.  J Am Coll Cardiol. 1998;  32 557-561
• 4 Pohjola-Sintonen S, Muller J E, Stone P H et al.. Ventricular septal and free wall rupture complicating acute myocardial infarction: experience in the Multicenter Investigation of Limitation of Infarct Size.  Am Heart J. 1989;  117 809-818
• 5 Eren E, Bozbuga N, Toker M E et al.. Surgical treatment of post-infarction left ventricular pseudoaneurysm: a two-decade experience.  Tex Heart Inst J. 2007;  34 47-51
• 6 Turgeman Y, Antonelli D, Rosenfeld T. Intermittent to-and-fro murmur in cardiac pseudoaneurysm: Doppler echocardiographic findings.  Int J Cardiol. 1990;  26 376-377
• 7 Birnbaum Y, Chamoun A J, Anzuini A, Lick S D, Ahmad M, Uretsky B F. Ventricular free wall rupture following acute myocardial infarction.  Coron Artery Dis. 2003;  14 463-470
• 8 Milgalter E, Uretzky G, Levy P, Appelbaum A, Borman J B. Pseudoaneurysm of the left ventricle.  Thorac Cardiovasc Surg. 1987;  35 20-25
• 9 Yeo T C, Malouf J F, Oh J K, Seward J B. Clinical profile and outcome in 52 patients with cardiac pseudoaneurysm.  Ann Intern Med. 1998;  128 299-305
• 10 Moreno R, Gordillo E, Zamorano J et al.. Long term outcome of patients with postinfarction left ventricular pseudoaneurysm.  Heart. 2003;  89 1144-1146