Difference between revisions of "Left ventricular pseudoaneurysm"

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==Background==
 
==Background==
*LV Pseudoaneurysm = acute MI causes ventricular free wall rupture that is contained by pericardial adhesions
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*Acute [[MI]] or surgical mishap causes ventricular free wall rupture <ref>Frances, C., Romero, A., and Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology; 32(3): 557 - 61</ref>
**Only small ones compatible with life
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**Contained by pericardial adhesions
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**Mortality rate high secondary to rupture of pseudoaneurysm
  
 
===Causes===
 
===Causes===
*Transmural MI (anterior most common)
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*Transmural [[MI]] (anterior or inferior most common)
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*Surgical mishap
  
 
==Clinical Features==
 
==Clinical Features==
*Can be asymptomatic
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*10% are asymptomatic <ref>Frances, C., Romero, A., Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology, 32(3); 557 - 61</ref>
*History of [[MI]]
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*History of [[MI]] or cardiac surgery
*Angina, [[shortness of breath]]/DOE
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*Symptoms similar to [[congestive heart failure]]
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**[[Angina]]
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**[[Shortness of breath]]
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*New cardiac murmur (70%)
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{ST elevation DDX}}
 
{{ST elevation DDX}}
  
==Evaluation==
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==Evaluation<ref>Frances, C., Romero, A., Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology, 32(3); 557 - 61</ref>==
*LV angiography (TTE unreliable)
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*[[ECG]]
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**Non-specific ST changes
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**[[ST elevation]] (20%)
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*[[CXR]]
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**Mass-like appearance
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*LV angiography
  
 
==Management==
 
==Management==
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==Complications==
 
==Complications==
 
*Angina (increased O2 demand)
 
*Angina (increased O2 demand)
*Complete LV rupture
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*Complete [[cardiac rupture|LV rupture]]
  
 
==See Also==
 
==See Also==
 
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*[[Left ventricular aneurysm]]
  
 
[[Category:Cardiology]]
 
[[Category:Cardiology]]

Latest revision as of 15:36, 25 September 2019

Background

  • Acute MI or surgical mishap causes ventricular free wall rupture [1]
    • Contained by pericardial adhesions
    • Mortality rate high secondary to rupture of pseudoaneurysm

Causes

  • Transmural MI (anterior or inferior most common)
  • Surgical mishap

Clinical Features

Differential Diagnosis

ST Elevation

Evaluation[3]

Management

  • Surgical repair = 10% 5 yr mortality
  • Medical therapy = 50% 5 yr mortality

Disposition

Complications

See Also

  • Frances, C., Romero, A., and Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology; 32(3): 557 - 61
  • Frances, C., Romero, A., Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology, 32(3); 557 - 61
  • Frances, C., Romero, A., Grady, D. (1998). Left ventricular pseudoaneurysm. Journal of the American College of Cardiology, 32(3); 557 - 61