Key result
Routine echocardiogram incidentally detects a 1.6cm LV pseudoaneurysm in an asymptomatic man following posterior MI.
Why the study?
Left ventricular pseudoaneurysms are a rare complication of myocardial infarction, and less is known about the natural history and rupture risk of chronic, incidentally found asymptomatic pseudoaneurysms compared to the mortality risk of surgical repair.
Case Report (n=1)
Highlights the clinical dilemma and multi-disciplinary management of chronic, asymptomatic left ventricular pseudoaneurysms discovered incidentally late after myocardial infarction.
Incidental chronic LV pseudoaneurysms create management uncertainty; leaves open optimal surveillance and intervention thresholds in asymptomatic patients.
Highlights: Left ventricular pseudoaneurysms are a rare mechanical complication of myocardial infarction. If found acutely following infarction (within 2 weeks, with some advocating up to 3 months), surgical repair is recommended due to their high risk of rupture.Whilst associated with chest pain, dyspnoea and heart failure, some individuals are asymptomatic, with the diagnosis made incidentally on routine follow-up often months to years post infarction. Less is known about the natural history of these chronic pseudoaneurysms, with concerns around their propensity to rupture perhaps less than the mortality risk of surgical repair.We present the case of a 70 year-old asymptomatic man who was found to have a 1.6cm left ventricular pseudoaneurysm found incidentally on routine transthoracic echocardiogram at 12-months post posterior myocardial infarction.The consensus opinion of our institution's multi-disciplinary team regarding further management of this patient, with reference to the current limited data on chronic pseudoaneurysms, will be discussed.
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Brooks et al. (2020) conducted a case report in Left ventricular pseudoaneurysm post myocardial infarction (n=1). A 1.6cm left ventricular pseudoaneurysm was found incidentally on routine transthoracic echocardiogram in a 70-year-old asymptomatic man 12 months post posterior myocardial infarction.
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