Key result
Optimal medical therapy was successfully utilized to manage a 73-year-old man presenting with an inferior-posterior wall STEMI complicated by a thrombosed pseudoaneurysm.
Why the study?
Left ventricular pseudoaneurysm is a rare, high-mortality complication usually managed aggressively, highlighting the need to assess individual presentation and the role of medical management in acute settings.
Case Report (n=1)
This case report highlights that medical management can be considered in acute settings for left ventricular pseudoaneurysm complicating STEMI based on individual clinical assessment.
Emphasizes caution managing post-MI pseudoaneurysm rupture risk; leaves open optimal strategies for this rare complication.
Left ventricular pseudoaneurysm is a rare complication associated with high morbidity and mortality when symptomatic and is usually managed aggressively to prevent or reduce risk of mortality. Herein, we present the case of a 73-year-old man who underwent coronary artery bypass grafting 10 years ago, now presenting with an inferior-posterior wall myocardial infarction complicated by pseudoaneurysm. This case highlights the need for individual clinical assessment of patient presentation with consideration for medical management in acute settings in patients with pseudoaneurysm of the left ventricle. Despite the natural history of rare complications with pseudoaneurysms such as rupture and potentially fatal cardiac tamponade, infections, and arrhythmias, it is important to note that pseudoaneurysms can present with coronary artery disease and congestive heart failure, and clinicians need to have an index of suspicion for pseudoaneurysms despite advancement in medical and interventional management of coronary artery disease.
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Adekoya et al. (2020) conducted a case report in Inferior-posterior wall STEMI complicated by pseudoaneurysm (n=1). Optimal medical therapy was evaluated. Optimal medical therapy was successfully utilized to manage a 73-year-old man presenting with an inferior-posterior wall STEMI complicated by a thrombosed pseudoaneurysm.
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