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[Pseudoaneurysm of the left ventricle: a report of 2 cases]
Insights
Diagnosing left ventricular pseudoaneurysms after myocardial infarction is crucial. Two-dimensional echocardiography with color Doppler is the best noninvasive method for detection and follow-up.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Left ventricular pseudoaneurysms (LVPs) are rare but serious complications following myocardial infarction.
- Early and accurate diagnosis is essential for timely intervention and improved patient outcomes.
Observation:
- Two cases of LVPs are presented, diagnosed using two-dimensional echocardiography and color Doppler.
- Echocardiography revealed echo-free spaces communicating with the left ventricle, confirmed by cardiac catheterization and surgery.
Findings:
- The study highlights the effectiveness of echocardiography in visualizing LVPs, including size, location, and communication with the left ventricle.
- Postoperative assessment revealed persistent or resolved shunts and varying degrees of left ventricular dysfunction.
Implications:
- Two-dimensional echocardiography with color Doppler is identified as the optimal noninvasive technique for diagnosing and monitoring LVPs.
- These findings underscore the importance of advanced imaging in managing post-myocardial infarction complications.
Abstract:
Two cases of left ventricular pseudoaneurysm following myocardial infarction are presented. In the first patient a two-dimensional echocardiography study revealed a small posterior echo-free space that appeared to communicate with the left ventricle through a small defect in the left ventricular posterior wall. Conventional Doppler echocardiography and colour flow imaging demonstrated flow between the left ventricle and the paraventricular chamber. In the other patient, the same study detected an enormous false aneurysm. We found a large extramyocardial echo-free space within the pericardial cavity. The site of this space was posterolateral and communicating with the left ventricular cavity. Cardiac catheterization and surgery confirmed the diagnosis. A postoperative echocardiographic study demonstrated a persistent but smaller saccular echo-free space and a residual shunt through one site of repair in the first patient; in the other, after surgical treatment there was no residual flow, but a left ventricular dysfunction was detected. Two dimensional and color Doppler echocardiography is the best technique among the noninvasive methods, for detecting and following up left ventricular pseudoaneurysms.