Left ventricular pseudoaneurysm

Background

  • Acute MI or surgical mishap causes ventricular free wall rupture [1]
    • Contained by pericardial adhesions
    • Morality 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]

  • Physical exam
    • New cardiac murmur (70%)
  • ECG
    • Non-specific ST changes
    • ST elevation (20%)
  • CXR
    • Mass-like appearance
  • LV angiography

Management

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

Disposition

Complications

  • Angina (increased O2 demand)
  • Complete LV rupture

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