| The contribution of non-invasive imaging modalities to the diagnosis of left ventricular pseudoaneurysm. | |
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MedLine Citation:
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PMID: 12638339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Left ventricular pseudoaneurysm (LVPA) is a rare entity characterized by a tendency to spontaneous rupture due to its morphology, a lack of myocardial fibers and fibrous tissue delineating the cavity. An early diagnosis is essential in order to guide appropriate therapy. PURPOSE: To determine the diagnostic accuracy of different imaging techniques, treatment results, and prognosis of patients (pts) with LVPA. METHODS: We evaluated the incidence of LVPA during a five-year period. The initial clinical presentation, the etiology of LVPA, time between symptom onset and diagnosis, and use of various non-invasive techniques were studied. Mean follow-up was 15 months. RESULTS: Of 19113 pts admitted to our Institute in a five-year period, LVPA was diagnosed in 11 pts (0.05%) (mean age 51 +/- 3.9 years, 8 men). The diagnosis of LVPA was confirmed by surgery in 4 pts, and by pathology in 2 pts. LVPA was an incidental finding in one asymptomatic pt, it was diagnosed in 6 pts presenting with an acute myocardial infarction (AMI) and in 4 pts presenting with LV failure. The main etiology was coronary artery disease (CAD) (9 pts), with the remaining 2 cases being post-traumatic (thoracic stab wound, surgery). LVPA location was postero-inferior in 6 patients, infero-lateral in 3 patients, and anterior in 2 patients. ECG, X-ray and TTE were performed in all cases. 6 pts had a radionuclide angiography (RNA), 3 pts had a computed tomography (CT) scan and 2 pts had a magnetic resonance imaging (MRI) study. Two-dimensional transthoracic echocardiography (TTE) provided information regarding LVPA dimensions and LV-LVPA flow. Four pts were operated (one died). Of the seven non-operated pts., 5 died. CONCLUSIONS: The clinical presentation was variable and non-specific. The most frequent cause of LVPA was MI and the most frequent location was inferior. Echocardiography offered the most reliable information when compared to ventriculography. Because clinical examination, ECG, X-ray data are non-specific for the diagnosis of LVPA, an adequate TTE study performed with a high clinical index of suspicion (especially in pts with inferior MI or thoracic trauma) could facilitate the early diagnosis of LVPA and could be relevant to outcome. |
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Authors:
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Bogdan A Popescu; Carmen Ginghina; Ioan M Coman; Ioana Stoian; Adina Stoica; Dan Stanescu; Serban A L Georgescu; Bradu Fotiade; Eduard Apetrei |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Przegla̧d lekarski Volume: 59 ISSN: 0033-2240 ISO Abbreviation: Prz. Lek. Publication Date: 2002 |
Date Detail:
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Created Date: 2003-03-17 Completed Date: 2003-05-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 19840720R Medline TA: Przegl Lek Country: Poland |
Other Details:
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Languages: eng Pagination: 642-5 Citation Subset: IM |
Affiliation:
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Prof. Dr. C. C. Iliescu Institute of Cardiovascular Diseases, Sos. Fundeni 258, sector 2, 72435, Bucharest, Romania. abpope07@cmb.ro |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aneurysm, False
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diagnosis*,
etiology*,
surgery Diagnosis, Differential Echocardiography Electrocardiography Female Follow-Up Studies Heart Aneurysm / diagnosis Heart Diseases / complications*, diagnosis* Humans Magnetic Resonance Imaging Male Middle Aged Myocardial Infarction / complications Prognosis Tomography, X-Ray Computed Treatment Outcome Ventricular Dysfunction, Left / etiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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