Left ventricular false-pseudo and pseudo aneurysm: serial observations by cardiac magnetic resonance imaging.
A case of extensive inferior myocardial infarction complicated by a large ventricular aneurysm is presented. Magnetic resonance (MR) imaging 4 days after the onset showed a small protrusion from the necrotic inferior myocardium, which expanded 10 days after onset with a marked pericardial effusion. The follow-up examination by MR and CT imaging 6 months after the onset revealed a large ventricular aneurysm from the inferior cardiac wall. After the aneurysmectomy, the histological study revealed that the aneurysm wall was made up of 2 different types of walls; the peripheral part was a false-pseudo aneurysm and the central part was a pseudo aneurysm. From the serial MR imaging, it is considered that such an aneurysm is primarily formed from a small discontinuation of the LV wall followed by oozing type rupture. Finally, the ruptured central part of the LV wall, which was covered by the pericardium, formed a pseudo aneurysm and the stretched peripheral area, which contains myocardium, formed a false-pseudo aneurysm afterward and then they extended together. Thus, MR imaging provided the important information for the understanding of the formation process of the pseudo and false pseudo LV aneurysm.
Ando
Shin-ichi
S
Cardiology Division, Fukuokaken Saiseikai Futsukaichi Hospital, Fukuoka, Japan. shinando@ab.mbn.or.jp
Kadokami
Toshiaki
T
Momii
Hidetoshi
H
Hironaga
Kiyoshi
K
Kawamura
Natsumi
N
Fukuyama
Takaya
T
Minato
Naoki
N
D017541:Aneurysm, False / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D017023:Coronary Angiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006352:Heart Ventricles; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome