An Asymptomatic Left Ventricular Pseudoaneurysm found incidentally at 12 months post Myocardial Infarction: Case Report and Review of the Literature

Authors

  • Christian Brooks John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia https://orcid.org/0000-0002-6782-0711
  • Heather Cooke John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia

DOI:

https://doi.org/10.17987/icfj.v20i0.697

Keywords:

Cardiac catheterisation, Echocardiography, Left Ventricular Pseudoaneurysm, Myocardial Infarction.

Abstract

Highlights: 

Left ventricular pseudoaneurysms are a rare mechanical complication of myocardial infarction. If found acutely following infarction (within 2 weeks, with some advocating up to 3 months), surgical repair is recommended due to their high risk of rupture.

Whilst associated with chest pain, dyspnoea and heart failure, some individuals are asymptomatic, with the diagnosis made incidentally on routine follow-up often months to years post infarction. Less is known about the natural history of these chronic pseudoaneurysms, with concerns around their propensity to rupture perhaps less than the mortality risk of surgical repair.

We present the case of a 70 year-old asymptomatic man who was found to have a 1.6cm left ventricular pseudoaneurysm found incidentally on routine transthoracic echocardiogram at 12-months post posterior myocardial infarction.

The consensus opinion of our institution's multi-disciplinary team regarding further management of this patient, with reference to the current limited data on chronic pseudoaneurysms, will be discussed.

Author Biographies

Christian Brooks, John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia

Dr Brooks has just successfully completed the Royal Australian College of Physicians' Basic Physician Training programme. From 2020 onwards, he will be working within the Hunter New England Local Health District in New South Wales, Australia, as an Advanced Physician Trainee in General Medicine.

Throughout his training to-date, Dr Brooks has always enjoyed cardiology terms and has encountered several interesting cases. He is keen to contribute to the literature and to learn more about cardiology, and following completion of General Medicine Advanced Training, plans to dual-train and undertake a dedicated Cardiology Advanced Training program.

Heather Cooke, John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia

Dr Heather Cooke is a staff specialist cardiologist at the John Hunter Hospital, New Lambton Heights, NSW, Australia. Dr Cooke is a registered specialist with the FRACP and a member of both the American and Canadian Societies of Echocardiography.After completing her general cardiology training in Queensland she undertook the first of two fellowships in cardiac imaging at the prestigious Peter Munk Cardiac Centre in Toronto, Canada.Furthering her interest in cardiac imaging, and particularly the role of imaging in coronary artery disease, Dr Cooke undertook a second fellowship in Nuclear cardiology, also in Toronto Canada. 

References

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Published

2020-08-07

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Letters to the Editor