[Mild clinical course of left ventricular pseudoaneurysm]

Abstract

Left ventricular pseudoaneurysm from myocardial infarction is rare but is associated with a high risk of rapid enlargement and rupture. This report describes a 57 year old woman with left ventricular pseudoaneurysm and delayed surgical repair. Seven weeks after myocardial infarction control transthoracic echocardiography revealed a inferolateral left ventricular pseudoaneurysm. Early surgical intervention was recommended but the patient refused hospitalization and surgical repair and continued every day home activity. The symptoms and signs were so mild that she was qualified to 1st class of NYHA classification and 1st class of CCS classification. Six weeks later-ventriculography confirmed the primary diagnosis. During heart surgery the pseudoaneurysm was incised, its fibrous wall with thrombus was resected and the ruptured left ventricular myocardium was satured. She had an uneventful postoperative course. Definitive diagnosis of the pseudoaneurysm was confirmed by histopathological evaluation of the excised left ventricular wall.