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Case Reports
. 2024 Jan 1;16(1):e51480.
doi: 10.7759/cureus.51480. eCollection 2024 Jan.

Left Ventricular Pseudoaneurysm: A Rare but Fatal Complication of Myocardial Infarction

Sehajpreet Singh  1 , Jasveen Kaur  1 , Arjun Basnet  1 , Ravi Jayanti  2 , Bilal A Malik  2
Affiliations
Case Reports

Left Ventricular Pseudoaneurysm: A Rare but Fatal Complication of Myocardial Infarction

Sehajpreet Singh et al. Cureus. .

Abstract

Left ventricular pseudoaneurysm is a ventricular free wall rupture contained within the adjacent adherent pericardium or scar tissue. Myocardial infarction (MI), cardiac surgery, and chest trauma are the common causes. The most common presenting symptoms of pseudoaneurysms are congestive heart failure, chest pain, and dyspnea, but a small percentage of patients may be asymptomatic. Early diagnosis and treatment are of prime importance because of the tendency of pseudoaneurysms to expand and rupture, with a high mortality rate, especially if left untreated. We present a case of a 65-year-old man who was found to have left ventricular pseudoaneurysm on a follow-up echocardiography within three weeks of an MI. He subsequently underwent patch repair and was discharged after medical optimization. Our case highlights the importance of maintaining a high clinical suspicion of pseudoaneurysm in a patient post-MI, as delayed diagnosis and treatment can be fatal.

Keywords: cardiac surgical procedures; cardiology imaging; left ventricular pseudoaneurysm; myocardial infarction; myocardial rupture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Electrocardiography (ECG) on arrival
Electrocardiography (ECG) on arrival showed sinus rhythm with minimal ST-segment elevation in the lateral leads and minimal ST-segment depression in the inferior leads.
Figure 2
Figure 2. Repeat electrocardiography
Repeat electrocardiography showed worsening ST-segment elevations in the lateral leads.
Figure 3
Figure 3. 2D-TTE (apical four-chamber view)
The image shows a thinned-out LV lateral wall and a contained LV free wall rupture with the formation of a large (8 cm) Pseudoaneurysm. 2D-TTE: Two-dimensional transthoracic echocardiography, LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle, PsA: pseudoaneurysm.
Figure 4
Figure 4. 2D-TTE (apical four-chamber view)
The image shows contained pseudoaneurysm of LV lateral wall consistent with Hemashield patch repair. 2D-TTE: Two-dimensional transthoracic echocardiography, LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle, PsA: Pseudoaneurysm
See this image and copyright information in PMC

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