Calcified Cardiac Aneurysms

THE term cardiac aneurysm was first used to signify general enlarge-ment of the heart cavities, but in recent years it has been reserved for local pouches or sacs in the heart wall.1 Combining reported data, Parkinson, Bedford and Thomson2 state that cardiac aneurysm occurs in 9 per cent of cases of cardiac infarction examined at necropsy. Other observers3 report an incidence of 37 per cent, but they must include, as Crawford4 points out, even small indentations of the endocardial wall at the site of an old infarct. He feels that the term cardiac aneurysm "should be confined to a permanent localized bulging, or during systole, a well marked localized expansion be-yond the contour of the rest of the heart." In the majority of cases, cardiac aneurysms follow myocardial infarction. The remaining few are due to syphilis (gumma), bacterial infection (abscess or embolus), rheumatic myocarditis; or are of congenital or trau-matic origin. In 1939, Gubner and Crawford 5 demonstrated, by roentgen-kymographic studies, that bulging takes place during systole in a large