Left ventricular pseudoaneurysm. A clinical case report

Paulius Burkauskas1, Laurynas Skrodenis1, Ligita Bespalovaitė1, Julius Vidikas2

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

2Lithuanian research center of health sciences

Abstract

Introduction: left ventricular pseudoaneurysm is a complication whose main etiological factor is  myocardial infarction. This acute condition is formed when blood is trapped and confined to the pericardium or scar  tissue after ruptures in the free wall of the ventricle. The development of pseudoaneurysm requires immediate  assessment of the patient’s condition and treatment due to the high risk of rupture. Almost 50% of patients with this  disease do not feel any symptoms. For this reason, pseudoaneurysm is diagnosed as early as complications occur, or  by random routine examinations. The suspicion may also be caused by changes in the plain chest roentgenogram. To  confirm the diagnosis, a computed tomography or magnetic resonance imaging is performed. The treatment is  performed by a surgery or percutaneous procedure, and the more appropriate one is selected according to the patient’s  functional condition. This paper presents a clinical case when a patient develops pseudoaneurysm after a left  ventricular myocardial infarction and discusses its diagnostic and treatment options.

Aims: to present the clinical case in the hospital of the Lithuanian University of Health Sciences. To select  and analyze the causes, diagnostic and treatment recommendations of left ventricular pseudoaneurysm provided by  experts.

Methods: the review of literature was conducted using the medical database, selecting publications  investigating the burden of left ventricular pseudoaneurysm.

Results: after analysis of the literature main causes, diagnostics and treatment methods of left ventricular  pseudoaneurysm are presented. 

Conclusions: left ventricular pseudoaneurysm is a life-threatening pathology that most commonly occurs  after a lower wall myocardial infarction. In radiological images of patients with a history of myocardial infarction, an  increased risk of pseudoaneurysm should always be considered if an enlarged cardiac cavity is observed. Keywords: left ventricle pseudoaneurysm, miocardial infarction, left ventricle dilation.

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