Document Detail

Pseudoaneurysm of the left ventricle progressing from a subepicardial aneurysm.
MedLine Citation:
PMID:  10462024     Owner:  NLM     Status:  MEDLINE    
A 56-year-old man presented with an inferior myocardial infarction and a huge pseudoaneurysm below the inferior surface of the left ventricle, which had progressed from a small subepicardial aneurysm over a 6-month period. Transthoracic echocardiography, Doppler color flow images, radionuclide angiocardiography, magnetic resonance imaging and contrast ventriculography all revealed an abrupt disruption of the myocardium at the neck of the pseudoaneurysm, where the diameter of the orifice was smaller than the aneurysm itself, and abnormal blood flows from the left ventricle to the cavity through the orifice with an expansion of the cavity in systole and from the cavity to the left ventricle with the deflation of the cavity in diastole. Coronary angiography revealed 99% stenosis at the atrioventricular nodal branch of the right coronary artery. At surgery the pericardium was adherent to the aneurysmal wall and a 1.5-cm orifice between the aneurysm and the left ventricle was seen. Pathological examination revealed no myocardial elements in the aneurysmal wall. The orifice was closed and the postoperative course was uneventful. Over-intense physical activity as a construction worker was considered to be the cause of the large pseudoaneurysm developing from the subepicardial aneurysm. These findings indicate that a subepicardial aneurysm may progress to a larger pseudoaneurysm, which has a propensity to rupture, however, it can be surgically repaired.
H Koito; C Nakamura; J Suzuki; H Kamihata; Y Takayama; T Iwasaka; H Imamura
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  63     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-10-08     Completed Date:  1999-10-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  559-63     Citation Subset:  IM    
Second Department of Internal Medicine/Cardiovascular Center, Kansai Medical University, Moriguchi, Japan.
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MeSH Terms
Aneurysm, False / diagnosis,  etiology*
Aneurysm, Ruptured / etiology
Angiography, Digital Subtraction
Echocardiography, Doppler, Color / methods
Heart Aneurysm / complications,  diagnosis*,  etiology
Magnetic Resonance Imaging
Middle Aged
Myocardial Infarction / complications
Radiography, Thoracic
Rupture, Spontaneous / etiology
Ventricular Dysfunction, Left / diagnosis*,  etiology

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