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Case Reports
. 2015 Jul 26;7(7):431-3.
doi: 10.4330/wjc.v7.i7.431.

Giant and thrombosed left ventricular aneurysm

Jose Alberto de Agustin  1 , Jose Juan Gomez de Diego  1 , Pedro Marcos-Alberca  1 , Jose Luis Rodrigo  1 , Carlos Almeria  1 , Patricia Mahia  1 , Maria Luaces  1 , Miguel Angel Garcia-Fernandez  1 , Carlos Macaya  1 , Leopoldo Perez de Isla  1
Affiliations
Case Reports

Giant and thrombosed left ventricular aneurysm

Jose Alberto de Agustin et al. World J Cardiol. .

Abstract

Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

Keywords: Coronary angiography; Coronary artery disease; Echocardiography; Left ventricular aneurysm; Myocardial infarction.

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Figures

Figure 1
Figure 1
Transthoracic echocardiogram using apical three chamber view showing the big anterior left ventricular aneurysm (arrow). The wall of the aneurysm was calcified (arrowheads), and the aneurysm was covered with thrombus (arrow). LA: Left atrium; LV: Left ventricle.
Figure 2
Figure 2
Transthoracic echocardiogram using parasternal short axis view at the midventricular level showing the thrombus (arrow) covering the anterior wall aneurysm. LV: Left ventricle.
Figure 3
Figure 3
Three-dimensional echocardiography in apical four chamber view showing the big size of the aneurysm (arrows). LA: Left atrium; LV: Left ventricle.
Figure 4
Figure 4
Left coronary angiography demonstrating a proximal occlusion of the left anterior descending artery (arrow). CX: Circumflex coronary artery; LAD: Left anterior descending coronary; LM: Left main coronary artery.
Figure 5
Figure 5
Fluoroscopic imaging in right anterior oblique projection showing a complete oval calcified mass (arrows), corresponding with the left ventricular aneurysm.
Figure 6
Figure 6
Left ventriculogram confirming diagnosis of a giant calcified and partially thrombosed left ventricular aneurysm, with severe left ventricular systolic dysfunction. The wall of the aneurysm is calcified (arrowheads), and the aneurysm is covered with thrombus (arrows). LV: Left ventricle.
See this image and copyright information in PMC

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