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Rapidly Progressing Fatal Left Ventricular Pseudoaneurysm After Acute Myocardial Infarction - A Case Report of

Yuan Zheng1, Wei Zhu2, Xinjie Huang3

  • 1Department of Cardiothoracic Surgery, Guangdong Provincial Hospital of Chinese Medicine, People's Republic of China. yuanzheng591@gmail.com.

The Heart Surgery Forum
|May 11, 2021
PubMed

Insights

Left ventricular pseudoaneurysm (LVPA), a rare complication of myocardial infarction (MI), requires prompt surgical intervention. This case highlights that delayed diagnosis and treatment of LVPA can lead to fatal rupture.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Left ventricular pseudoaneurysm (LVPA) is a rare but life-threatening complication following acute myocardial infarction (MI).
  • LVPA is characterized by a rupture contained only by the pericardium, increasing the risk of catastrophic rupture.
  • Surgical intervention is often necessary for managing LVPA due to its inherent instability.

Observation:

  • A 60-year-old male presented with acute MI due to complex coronary artery occlusion.
  • Transthoracic echocardiography (TTE) initially revealed a small ventricular aneurysm 11 days post-MI.
  • A follow-up TTE on day 26 demonstrated rapid progression to a significant LVPA.

Findings:

  • The patient's LVPA progressed rapidly between echocardiographic assessments.
  • Despite plans for emergency cardiac surgery, the patient succumbed to LVPA rupture prior to intervention.

Implications:

  • This case underscores the critical importance of early and accurate diagnosis of LVPA post-MI.
  • Timely surgical repair is paramount for improving patient outcomes and preventing mortality from LVPA rupture.
  • Advanced imaging modalities like TTE play a crucial role in monitoring LVPA progression and guiding treatment decisions.

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