Inferior wall ventricular aneurysm: a rare late complication of myocardial infarction. Importance of timely diagnosis

Abstract

Introduction: Ventricular aneurysm presents as a late mechanical complication of Acute Myocardial Infarction; it is generally reserved to designate an isolated dyskinetic area of the left ventricular wall with a wide neck. The incidence of an inferior-posterior or lateral wall aneurysm is very low, approximately 5% to 10%. This entity increases the risk of mortality, even when compared to that of patients with similar left ventricle ejection fraction. Objective: To establish the importance of the timely diagnosis of a rare and late complication of acute myocardial infarction. Case presentation: A patient with history of acute inferior myocardial infarction and episodes of recurrent ventricular tachycardia with an echocardiographic diagnosis of a large aneurysm in the inferior and lateral wall with thrombi inside is described in this paper. Medical treatment was optimized, and an implantable cardioverter-defibrillator was indicated. Conclusions: The presence of a true ventricular aneurysm in the infero-lateral wall is a rare late complication of acute myocardial infarction; ventricular tachycardia is one of the forms of presentation of this entity. Regular follow-up of the patient after the event leads to timely diagnosis and appropriate treatment.

Keywords

• aneurisma de ventrículo izquierdo, infarto de miocardio, taquicardia ventricular, ecocardiograma.