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False aneurysms of the left ventricle. Identification of distinctive clinical, radiographic, and angiographic
Insights
False left ventricular aneurysms, often caused by coronary artery disease, differ from true aneurysms in location and cause. Distinguishing these conditions is crucial due to the high rupture risk of false aneurysms.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Radiology
Background:
- False aneurysms of the left ventricle are rare but serious complications.
- They can arise from various causes including myocardial infarction, infection, trauma, or surgical complications.
Purpose of the Study:
- To describe the characteristics of false left ventricular aneurysms.
- To differentiate them from true left ventricular aneurysms.
- To highlight the clinical significance and potential complications.
Main Methods:
- Retrospective review of 14 patients with false left ventricular aneurysms.
- Analysis of medical history, imaging studies (radiography, angiography), and clinical outcomes.
Main Results:
- Common causes included obstructive coronary arterial disease with myocardial infarction (11/14).
- False aneurysms typically presented posteriorly on lateral radiographs, unlike anterior true aneurysms.
- Angiography often showed diaphragmatic/posterolateral involvement due to right coronary artery occlusion, contrasting with apical/anterolateral true aneurysms from left anterior descending artery occlusion.
Conclusions:
- False left ventricular aneurysms have distinct imaging and etiological features compared to true aneurysms.
- Accurate differentiation is vital due to the higher propensity for rupture in false aneurysms.
- Prompt diagnosis and management are essential for patient outcomes.
Abstract:
False aneurysms of the left ventricle were observed in 14 patients. They were caused by obstructive coronary arterial disease with resultant myocardial infarction in 11, bacterial endocarditis in 1, a knife wound in 1, and disruption of a ventriculotomy in 1. Most of them extended posteriorly on the lateral radiograph, as opposed to the usual anterior position of true aneurysms. Enlargement was frequently observed on sequential studies. Angiography usually demonstrated involvement of the diaphragmatic or posterolateral segment due to occlusion of the right coronary artery; in contrast, true aneurysms are apical or anterolateral and are due to occlusion of the left anterior descending artery. The frequency of rupture of false aneurysms points up the importance of dinstinguishing them from true aneurysms.