Left Ventricular Pseudo aneurysm: A case report

Abstract

Rupture of the free wall of the left ventricle (LV) is a catastrophic complication occurring in 4% of patients after myocardial infarction (MI) and in 23% of those who die of MI. It is caused by myocardial rupture contained within the pericardium and is characterized by the absence of true myocardial tissue in its wall unlike, a true aneurysm which involves the full myocardial wall thickness. Early diagnosis is mandatory using noninvasive modalities such as TTE and CMR or less commonly used nowadays invasive modalities such as coronary arteriography and left ventriculography. Due its high liability for fatal rupture urgent surgical intervention is of paramount importance in management of this pathology. We present a rare case of Left Ventricular Pseudo aneurysm in young patient who underwent previous surgery for peri-cardial effusion. The surgical goal is to preserve or to remodel the ventricular chamber anatomy. Left ventricular angiogram is the definitive test to clinch the correct diagnosis. A high index of clinical suspicion is needed to avoid missing the diagnosis. This particular patient might have developed left ventricular pseudo aneurysm as a result of trauma from previous surgery

Keywords

• left ventricular pseudo aneurysm
• peri-cardial effusion
• catastrophic complication