Left ventricular pseudoaneurysm: An unexpected finding.

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Left ventricle pseudoaneurysm (LV PSA) is a rare but life-threatening condition resulting from left ventricle free wall rupture.
• It is often a complication of myocardial infarction, trauma, or infection, necessitating surgical repair to prevent cardiac tamponade and death.
• Distinguishing LV PSA from a true aneurysm is critical due to differing management strategies and prognoses.

Observation:

• A 63-year-old male heart transplant recipient presented with symptoms suggestive of acute cellular rejection.
• Cardiac magnetic resonance imaging (CMR), the preferred modality for assessing left ventricle morphology and function, revealed an unexpected LV PSA.
• This finding was incidental to the primary reason for admission.

Findings:

• The case highlights the potential for LV PSA to occur in heart transplant recipients, even in the absence of typical preceding events.
• Cardiac MRI successfully identified the LV PSA, underscoring its diagnostic utility.
• The patient's presentation complicated the diagnostic process, initially focusing on transplant rejection.

Implications:

• This case emphasizes the importance of maintaining a high index of suspicion for LV PSA in diverse patient populations, including transplant recipients.
• Prompt and accurate diagnosis via cardiac MRI is crucial for timely surgical intervention and improved patient outcomes.
• Further research may be warranted to explore the incidence and specific risk factors for LV PSA in heart transplant patients.