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Mending the broken valentine heart: a case report
Sarandeep Marwaha1, Raghav Bhatia1, Michael Papadakis1
1Department of Cardiology, St George's, University of London, St George's University Hospitals NHS Foundation Trust, London SW17 0RE, UK.
European Heart Journal. Case Reports
|August 22, 2022
Summary
Surgical resection of left ventricular (LV) aneurysm and thrombus improved LV function in a patient with severe impairment post-myocardial infarction (MI). This case highlights LV aneurysmectomy as a beneficial option for complex MI complications.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Mortality from myocardial infarction (MI) has decreased due to primary percutaneous intervention.
- Late complications like left ventricular (LV) dysfunction, aneurysms, and thrombus formation remain challenging.
- Surgical LV wall resection offers variable outcomes for selected complicated cases.
Observation:
- A 66-year-old man presented with dyspnea 2 years post-MI, exhibiting severe LV systolic impairment (23%) and a giant LV aneurysm with a large thrombus.
- The patient's condition had deteriorated from previous assessments.
- The LV aneurysm's appearance was described as resembling a Valentine heart.
Findings:
- The patient underwent successful resection of the LV aneurysm and thrombus.
- Post-surgery, the patient remained asymptomatic.
- Significant improvement in LV function was observed, increasing to 47% at 5 months post-operation.
Implications:
- Imaging and follow-up are crucial after large MI, especially after thrombus resolution.
- LV aneurysmectomy should be considered for patients with large LV aneurysms, severe LV impairment, and thrombus for prognostic and symptomatic benefits.
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