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Massive left ventricular pseudoaneurysm presenting as dysphagia: a case report.
Ashar Pirzada1, Kim Styles1, Robbie Stewart1
1Division of Cardiology, Department of Medicine, Dalhousie University, 1796 Summer St, Room 2132, Halifax Infirmary, Halifax, NS B3H 3A7, Canada.
European Heart Journal. Case Reports
|February 2, 2023
Summary
Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. This case highlights atypical symptoms of dysphagia and weight loss, emphasizing the need for prompt diagnosis and further research into optimal management strategies.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Imaging
Background:
- Left ventricular pseudoaneurysm (LVPA) is an uncommon complication of acute myocardial infarction (MI), often presenting with typical symptoms like heart failure or chest pain.
- Early reperfusion therapies for MI have reduced the incidence of LVPA.
- LVPA can manifest atypically, posing diagnostic challenges.
Observation:
- A 61-year-old male presented with dysphagia and weight loss, attributed to a massive left ventricular pseudoaneurysm.
- Imaging (echocardiogram, CT) confirmed the LVPA and its mass effect on gastrointestinal organs.
- Endoscopic evaluation ruled out organic gastrointestinal causes.
Findings:
- The LVPA caused significant mass effect, leading to atypical symptoms of dysphagia and weight loss.
- Surgical intervention was attempted but ultimately unsuccessful.
- Diagnostic modalities like echocardiography, CT, and cardiac MRI are crucial for identifying LVPA.
Implications:
- This case underscores the importance of considering LVPA in patients with unexplained gastrointestinal symptoms, even with atypical presentations.
- Further research is needed to establish optimal management strategies, balancing conservative versus surgical approaches for chronic pseudoaneurysms.
- Prompt diagnosis and tailored management are critical for improving prognosis in patients with left ventricular pseudoaneurysm.
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