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Ventricular aneurysm following myocardial infarction
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Cineradiography reveals cardiac pulsation abnormalities in most myocardial infarction survivors. Dynamic ventricular aneurysms were found in eight patients, impacting functional recovery and showing ECG changes.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Transmural myocardial infarction can lead to long-term cardiac complications.
- Assessing cardiac pulsation abnormalities is crucial for understanding post-infarction cardiac function.
Purpose of the Study:
- To evaluate the utility of cineradiography in studying cardiac pulsations after myocardial infarction.
- To identify the prevalence and characteristics of pulsation abnormalities, including dynamic ventricular aneurysms, in patients with a history of myocardial infarction.
Main Methods:
- Cineradiographic examination was performed on 50 consecutive patients with a history of transmural myocardial infarction at least six months prior.
- Patients were assessed for abnormalities in cardiac pulsation and the presence of dynamic ventricular aneurysms.
Main Results:
- Thirty-six out of 50 patients exhibited abnormal cardiac pulsations.
- Eight patients developed dynamic ventricular aneurysms, with six experiencing severe infarcts; these patients showed less complete functional recovery.
- No systemic emboli were observed in patients with dynamic aneurysms, and three of five patients with persistent ST-segment elevation and T-wave abnormalities had aneurysms.
Conclusions:
- Cineradiography is an effective method for detecting cardiac pulsation abnormalities post-myocardial infarction.
- Dynamic ventricular aneurysms are a significant complication associated with impaired functional recovery, though they may not correlate with systemic emboli or specific ECG findings.
Abstract:
Cineradiographic examination appears to be the best method for the study of cardiac pulsations. Fifty consecutive patients, who had sustained transmural myocardial infarction at least six months previously, were studied by this technique. Thirty-six had some abnormality of pulsation and eight had dynamic ventricular aneurysm. Six of the eight had suffered severe infarct. Functional recovery in those with aneurysm was not as complete as in the rest of the group. Two made a poor functional recovery, two a fair recovery, and four a moderately good recovery. Clinically, there were no systemic emboli in the patients with dynamic aneurysms. Five of the 50 had persistent ST-segment elevation and "coving" of the T waves; three of these patients had aneurysms. There was no good correlation between the electrocardiographic site of the infarct and the site of the abnormal pulsation.