title: Cardiac CT and MRI guide surgery in impending left ventricular rupture after acute myocardial infarction.
abstract: We report the case of a 67 year-old patient who presented with worsening chest pain and shortness of breath, four days post acute myocardial infarction. Contrast enhanced computed tomography of the chest ruled out a pulmonary embolus but revealed an unexpected small subepicardial aneurysm (SEA) in the lateral left ventricular wall which was confirmed on cardiac magnetic resonance imaging. Intraoperative palpation of the left lateral wall was guided by the cardiac MRI and CT findings and confirmed the presence of focally thinned and weakened myocardium, covered by epicardial fat. An aneurysmorrhaphy was subsequently performed in addition to coronary bypass surgery and a mitral valve repair. The patient was discharged home on post operative day eight in good condition and is feeling well 2 years after surgery.
authors.affiliation: Russell H, Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jclauss1@jhmi.edu
authors.forename: Jens
authors.initials: J
authors.lastname: Vogel-Claussen
authors.forename: Jan
authors.initials: J
authors.lastname: Skrok
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
authors.forename: João Ac
authors.initials: JA
authors.lastname: Lima
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Shah
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
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