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Tribak M, Adanho CM, Elmourabit Y, Saadouni Y, Elkettani OEC, Leghlimi LH, Soufiani A, Bendagha N, Agoumy Z, Elmhadi S, Lachhab F, Marmade L, Moughil S. Incidental diagnosis of a large left ventricular pseudoaneurysm. Radiol Case Rep 2024; 19:4108-4112. [PMID: 39104447 PMCID: PMC11299581 DOI: 10.1016/j.radcr.2024.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 08/07/2024] Open
Abstract
Left ventricular pseudoaneurysm is a rare complication of myocardial infarction and represent a myocardial rupture contained within a pericardial space limited by adhesions. Differentiating it from a left ventricular aneurysm can be a real diagnostic challenge. We report a case of a 50-year-old man admitted for symptoms of left heart failure. Transthoracic echocardiography and cardiac computed tomography scan incidentally showed a large lateral left ventricular pseudoaneurysm measuring 75/50 mm in diameter. Patch closure was carried out under cardiopulmonary bypass. Postoperative follow up was uneventful. This case demonstrates the increasing detection of «incidental» left ventricular pseudoaneurysm with more frequent use of multimodality imaging techniques including cardiac CT scan.
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Affiliation(s)
- Mohammed Tribak
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Christ-Marion Adanho
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Yassine Elmourabit
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Youssef Saadouni
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Omar Ech-cherif Elkettani
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Lalla Hasna Leghlimi
- Department of Cardiovascular anesthesia” B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Aida Soufiani
- Department of Cardiology “A”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Nesma Bendagha
- Department of Cardiology “A”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Zineb Agoumy
- Department of Cardiology “A”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Samah Elmhadi
- Department of Cardiology “A”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Fadoua Lachhab
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Lahcen Marmade
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
| | - Said Moughil
- Department of Cardiovascular surgery “B”, Ibn Sina University Hospital, Mohamed V University, Rabat, Morocco
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Mathur M, Gupta S. Cardiac Pseudoaneurysm- A Death Defying Entity. J Clin Diagn Res 2016; 10:TD06-7. [PMID: 27504379 DOI: 10.7860/jcdr/2016/19956.7936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Abstract
A pseudoaneurysm refers to a contained rupture of the myocardium with a tenuous pericardium walling off the leak. It needs to be differentiated from a true aneurysm by the fact that there is lack of myocardial tissue in the wall of a pseudoaneurysm. The differentiation between the two is pertinent as true aneurysms can be treated medically while pseudoaneurysms require urgent surgical treatment. Untreated pseudoaneurysms carry a high risk of rupture and mortality. We report a case of cardiac pseudoaneurysm developing in a 46-year-old male who had suffered myocardial infarction four months back. The patient now presented with chest pain and dyspnoea. CECT chest revealed a partially thrombosed large pseudoaneurysm arising from the posterior wall of left ventricle. While the clinical diagnosis of this entity is difficult, CECT plays a pivotal role in the non-invasive detection of pseudoaneurysms.
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Affiliation(s)
- Manoj Mathur
- Associate Professor, Department of Radiodiagnosis, Government Medical College , Patiala, Punjab, India
| | - Saryu Gupta
- Assistant Professor, Department of Radiodiagnosis, Government Medical College , Patiala, Punjab, India
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Ohtani H, Katoh H, Saitoh T, Shiraki K, Saotome M, Urushida T, Satoh H, Washiyama N, Terada H, Yamashita K, Hayashi H. Left Ventricular Pseudo-False Aneurysm Detected With ECG-Gated Multidetector Computed Tomography and Cardiac Magnetic Resonance Imaging. Circ J 2010; 74:1986-8. [DOI: 10.1253/circj.cj-10-0285] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hayato Ohtani
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Hideki Katoh
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Takeji Saitoh
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Katsunori Shiraki
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Masao Saotome
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Tsuyoshi Urushida
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Hiroshi Satoh
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
| | - Naoki Washiyama
- Cardiovascular Surgery, Hamamatsu University School of Medicine
| | - Hitoshi Terada
- Cardiovascular Surgery, Hamamatsu University School of Medicine
| | | | - Hideharu Hayashi
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
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Zoffoli G, Mangino D, Venturini A, Terrini A, Asta A, Zanchettin C, Polesel E. Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature. J Cardiothorac Surg 2009; 4:11. [PMID: 19239694 PMCID: PMC2654444 DOI: 10.1186/1749-8090-4-11] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 02/24/2009] [Indexed: 11/10/2022] Open
Abstract
Rupture of the free wall of the left ventricle (LV) is a catastrophic complication occurring in 4% of patients after myocardial infarction (MI) and in 23% of those who die of MI. Rarely the rupture is contained by an adherent pericardium creating a pseudo-aneurysm. This clinical finding calls for emergency surgery. If no ruptures are detectable and myocardium wall integrity is confirmed, we are in the presence of a true aneurysm, which can be treated by means of elective surgery. Differentiation between these two pathologies remains difficult. We report the case of a patient with a true aneurysm, initially diagnosed as pseudo-aneurysm at our institution; we have reviewed the literature on this difficult diagnosis and outlined characteristic findings of each clinical entity.
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Affiliation(s)
- Giampaolo Zoffoli
- Department of Cardiac Surgery, Ospedale dell'Angelo, Via Paccagnella 11, 30174, Venice, Mestre, Italy.
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Left ventricular lateral wall pseudoaneurysm. COR ET VASA 2007. [DOI: 10.33678/cor.2007.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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