Global akinesis: inadvertent left ventricular "pseudoaneurysmogram".
With today's widespread use of thrombolytic therapy and primary coronary intervention, left ventricular (LV) pseudoaneurysms (PA) are now uncommon sequela of myocardial infarction. Nonetheless, when encountered, the decision of surgical versus medical therapy is not always clear. We present a patient who developed a massive postinfarct PA, likely due to refusal of therapy. The LV was initially believed to be globally akinetic on catheterization. Subsequent review revealed, however, that the left ventriculogram was, in reality, a psuedoaneurysmogram. The recommendation for surgical intervention in this patient was prompted by the need for coronary bypass as well as mitral valve repair.
Chen
Jack P
JP
Department of Cardiology, Saint Joseph's Hospital of Atlanta, Atlanta, GA, USA. chenjackapollo@yahoo.com
D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006328:Cardiac Catheterization; D003937:Diagnosis, Differential; D004452:Echocardiography; D006322:Heart Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D011859:Radiography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*