Non-invasive diagnosis of a false left ventricular aneurysm with radionuclide ventriculography

A false aneurysm of the left ventricle is an uncommon and usually fatal condition, although sometimes it may be successfully repaired with surgery. This report describes two cases of false left ventricular aneurysms detected by first-pass radionuclide ventriculography. The aneurysmal chamber with a small neck giving a characteristic hourglass configuration to the ventricle was clearly demonstrated in these cases. Contrast ventriculography showed similar findings. Cross-sectional echocardiography revealed the characteristics of the false aneurysm in the second case, but was unsuccessful in the first due to pulmonary emphysema. The first patient unfortunately died of a rupture of the false aneurysm but the second patient was treated successfully with surgery. Because of the marked tendency of false aneurysms to rupture, early and safe diagnosis is desirable. Therefore, when a patient shows signs of a left ventricular aneurysm, radionuclide angiography is recommended to differentiate false and true aneurysms non-invasively.