title: Cardiac CT for intraseptal pseudoaneurysm: impending double rupture of ventricular septum and left ventricular free wall.
abstract: A 71-year-old woman presented at our hospital with chest discomfort. Cardiac CT showed an impending double rupture; an intraseptal pseudoaneurysm had ruptured into the right ventricle, while the left ventricular free wall remained intact at this stage. After admission, the patient fell into cardiogenic shock. Emergency surgery was performed. The intraoperative findings included a double rupture of the ventricular septum and the left ventricular free wall. Double rupture is a rare but fatal complication of myocardial infarction. Early diagnosis is essential. Recently, cardiac CT has emerged as a valuable tool for patients with possible ischaemic disease. In this case, enhanced cardiac CT showed an impending double rupture of junctional-type. The static and dynamic images of intraseptal pseudoaneurysm by two-dimensional (2-D) CT, 3-D CT and 4-D CT presented here provide insights into the mechanisms behind, and the pathophysiology of, double ruptures. They also demonstrate the significance of cardiac CT for evaluating ischaemic heart disease.
authors: Critical Care Division, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.
authors: Hiroshi
authors: H
authors: Yamada
authors: Department of Anesthesiology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.
authors: Asako
authors: A
authors: Sakurai
authors: Department of Anesthesiology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.
authors: Aya
authors: A
authors: Higurashi
authors: Department of Anesthesiology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.
authors: Kohji
authors: K
authors: Takeda
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging*; D017809:Fatal Outcome; D005260:Female; D056973:Four-Dimensional Computed Tomography; D006322:Heart Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000293:injuries*; D006801:Humans; D021621:Imaging, Three-Dimensional; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000150:complications; D014057:Tomography, X-Ray Computed; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology
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