title: Failure of gated SPECT and echocardiography to detect large apical aneurysm secondary to hyperdynamic left ventricular wall at the aneurysm neck.
abstract: We present a patient with a history of coronary artery disease and exertional angina after an acute anterior myocardial infarction. Angiography and ventriculography revealed multivessel coronary artery disease and a large apical aneurysm. Echocardiography and gated SPECT studies were performed for further evaluation of ischemia and assessment of left ventricular function. Gated SPECT and echocardiography failed to detect a large apical aneurysm due to a hyperdynamic left ventricular wall at the neck of the aneurysm. This case demonstrates the importance of using multiple imaging modalities in the evaluation of ventricular function in the setting of coronary artery disease.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California, Irvine Medical Center, Orange, CA 92868-4080, USA. mmovahed@uci.edu
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Movahed
authors.forename: John
authors.initials: J
authors.lastname: Vu
authors.forename: Paul
authors.initials: P
authors.lastname: Lizotte
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004452:Echocardiography; D006322:Heart Aneurysm / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*