Dissecting Aneurysm of Left Atrium Following External Cardiac Massage

WE REPORT a dissecting aneurysm of the left atrium following external cardiac massage. Although many types of injuries can occur to the heart from external cardiac massage,1we found no reports of dissecting atrial aneurysms in that setting. Report of a Case A 73-year-old man who underwent mitral valve replacement in 1972 sustained a postoperative heart block that required placement of a permanent transvenous pacemaker, which required continuous anticoagulation with warfarin sodium. In August 1975 at the time of the pacemaker generator replacement, a chest roentgenogram demonstrated a slight bulge in the upper border of the left side of the heart. On Jan 21, 1977, his pacemaker failed, and cardiopulmonary resuscitation was initiated by allied health personnel. At the hospital a temporary transvenous pacemaker was installed. A chest roentgenogram demonstrated cardiomegaly with a massive bulge in the upper border of the left side of the heart (Fig 1). The