Pseudoaneurysm – ABC CARDIOL

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Research Letter

Infective Endocarditis: A Never-Ending Ordeal?

Catarina Gregório et al. Ana Beatriz Garcia Susana Gonçalves Nuno Guerra … Fausto J. Pinto Catarina Sousa

Introduction

Prosthetic valve endocarditis (PVE) is an uncommon but life-threatening condition. This report describes a challenging case of recurrent PVE with paravalvular complications requiring multiple surgical interventions.

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ABCIC

Case Report

Rare Presentation of Pseudoaneurysm Obstructing the Left Ventricular Inflow Tract in a Patient With Acute Myocardial Infarction

Janine Daiana Stürmer et al. Raphael dos Santos Silva Willer Cesar Bica Tiago Hansel Basile Vigil … Gabriel Soder Renata Pibernat de Moraes Mathias Silvestre de Brida Rodrigo Moraes Reis

Introduction

Left ventricular (LV) pseudoaneurysm is nowadays a rare but still potentially fatal complication of myocardial infarction (MI). Recent studies have estimated that following ST-elevation MI, 0.27 to 0.91% of patients develop mechanical complications. LV free wall rupture (VFWR) is estimated to occur in 0.01 to 0.52% of patients, showing a clear decrease in incidence associated with the widespread adoption of reperfusion therapy. Nonetheless, there has been no significant decrease in associated mortality rates and this complication remains an important determinant of outcomes after MI.

A pseudoaneurysm is formed when a cardiac rupture is contained by adherent pericardium or scar tissue, with no myocardial tissue. Transmural MI is the most common cause, usually following occlusion of the right coronary artery or the circumflex artery, therefore more often occurring on the posterior or lateral wall.

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Image

Evolved Inferior Wall Myocardial Infarction with Left Ventricular Pseudoaneurysm: A Diagnostic Dilemma

Sónia Gomes Coelho et al. Clara F. Jorge Pedro B. Carlos Anne Delgado Leopoldina Vicente

Introduction

The left ventricular (LV) pseudoaneurysm (PA) is a rare mechanical complication of acute myocardial infarction (AMI). It results from myocardial rupture, in which the hemorrhagic process is contained by the adherent pericardium. It occurs most commonly in the inferior and posterior ventricular wall, since the rupture of the anterior ventricular wall usually leads to cardiac tamponade and immediate death, while the inferior-posterior face of the heart rests on the diaphragm, facilitating the ventricular cavity containment by the pericardium.^– Imaging methods are crucial to establish the diagnosis. Transthoracic (TTE) and transesophageal echocardiography (TEE) allow the definitive diagnosis in 26% and 75% of cases, respectively.^, Cardiac magnetic resonance (CMR) imaging is useful in the differential diagnosis of LV PA and aneurysm, with a reported sensitivity of 100%. The presence of late pericardial enhancement in the CMR is highly suggestive of LV PA, which may represent the effect of the passage of blood into the pericardial space at the time of myocardial rupture, with subsequent pericardial inflammation and fibrosis.^{, ,}

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Infective Endocarditis: A Never-Ending Ordeal?

Introduction

Rare Presentation of Pseudoaneurysm Obstructing the Left Ventricular Inflow Tract in a Patient With Acute Myocardial Infarction

Introduction

Evolved Inferior Wall Myocardial Infarction with Left Ventricular Pseudoaneurysm: A Diagnostic Dilemma

Introduction

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