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Myocardial Infarction With Ventricular Wall Aneurysm: A Case Report
Raviprakash Meshram1, Vikas Vaibhav2, Shruti Agrawal3
1Forensic Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Insights
A true ventricular aneurysm, a rare myocardial infarction complication, involves the heart
Area of Science:
- Cardiology
- Pathology
Background:
- Ventricular aneurysms, true or false, are rare complications of myocardial infarction.
- True aneurysms arise from intra-myocardial dissecting hematomas, weakening the myocardium.
- Ventricular wall rupture, often fatal, occurs 2-4 days post-myocardial infarction due to myocardial tissue lysis.
Abstract:
A ventricular aneurysm can be pseudo or true; it is a rare complication of myocardial infarction induced by an intra-myocardial dissecting hematoma due to fragile myocardium. Ventricular wall rupture takes place two to four days after myocardial infarction when coagulative necrosis and inflammatory infiltrate and lysis of myocardial connective tissue results in weakening of infarcted myocardium. Acute cardiac wall ruptures are mostly fatal; an unwittingly located pericardial adhesion can abort a rupture resulting in a false aneurysm. The wall of a false aneurysm consists of the epicardium in contrast to a true aneurysm, which is composed of the myocardium. True aneurysms are complications seen in transmural infarcts. Thinned-out scar tissue paradoxically bulged during systole, and toughened fibrotic wall rupture doesn't usually occur. Deaths in subjects with true ventricular aneurysms occur due to mural thrombus, arrhythmias, and heart failure. We encountered a case of a true aneurysm, as reported below.
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