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Pseudoaneurysm following lateral wall myocardial infarction

D P Sinha1, U Saha, D Mukherjee

  • 1Department of Cardiology, IPGME&R, Kolkata 700020.

The Journal of the Association of Physicians of India
|April 26, 2005
PubMed

Insights

Pseudoaneurysm (PA) formation in the left ventricle (LV) after acute myocardial infarction (AMI) is rare and serious. This case highlights a patient diagnosed with LV PA, who refused surgery and was discharged in stable condition.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Pseudoaneurysm (PA) of the left ventricle (LV) is an uncommon complication following acute myocardial infarction (AMI).
  • PAs are often associated with a poor prognosis, necessitating prompt diagnosis and management.
  • Early identification is crucial for patient outcomes.

Observation:

  • A 55-year-old male presented with symptoms of AMI and heart failure, including a systolic murmur.
  • Transthoracic and transesophageal echocardiography confirmed a PA of the LV lateral wall.
  • Cardiac MRI and coronary angiography were performed, revealing a significant lesion in the obtuse marginal artery (OM1).

Findings:

  • The patient was diagnosed with a left ventricular pseudoaneurysm secondary to acute myocardial infarction.
  • Coronary angiography identified a 60% stenosis at the origin of the major obtuse marginal artery (OM1).
  • Despite the diagnosis and recommendation for surgical intervention, the patient opted for discharge against medical advice.

Implications:

  • This case underscores the importance of comprehensive diagnostic imaging in suspected post-MI complications.
  • The patient's refusal of surgical treatment highlights challenges in managing rare cardiac conditions.
  • Further research into non-surgical management or long-term outcomes of conservative treatment for LV PAs is warranted.

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