Left ventricular aneurysm

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[edit] Discussion of Left ventricular aneurysm

  • Both true aneurysms and false ventricular aneurysms are the sequelae of myocardial infarction. However, their etiology, pathologic findings, diagnostic findings, and treatment are different.
  • True ventricular aneurysm is a chronic complication of myocardial infarction.
  • A true aneurysmal sac contains the endocardium, epicardium, and thinned fibrous tissue (scar) that is a remnant of the left ventricular muscle, whereas a false aneurysmal sac represents a pericardium that contains a ruptured left ventricle.
  • A true aneurysm, particularly if small, may cause no symptoms and is compatible with prolonged survival.
  • Unlike a true aneurysm, which contains some myocardial elements in its wall, the walls of a false aneurysm are composed of organized hematoma and pericardium and lack any element of the original myocardial wall.
  • An important difference is the lower potential for rupture of a true aneurysm compared with a false aneurysm.
    • Rupture of a true aneurysm is an uncommon phenomenon; therefore, surgical resection is necessary only when refractory angina pectoris, congestive heart failure, systemic embolization, or refractory arrhythmias are present.
    • In contrast, false aneurysms may rupture and require surgical repair.

[edit] Imaging Findings for Left ventricular aneurysm

[edit] ECG

  • True aneurysms distort the shape of the left ventricle during both diastole and systole, and the motion of the aneurysmal segment is paradoxical.
  • A true aneurysm has a wide neck, and the diameter of the neck is comparable with the maximal diameter of the aneurysm.

[edit] Plain film

  • One of the common imaging findings for differentiating true aneurysms from false aneurysms is location, which may be identified on a conventional chest radiograph.
  • The presence of a discrete bulge in the heart anteriorly is suggestive of a true aneurysm.

[edit] CT

  • True aneurysms will have a wide neck and are often apical in location.
  • False aneurysms will have a narrow neck and are often posterior diaphragmatic in loccation.

[edit] Images

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[edit] See Also

[edit] External Links

[edit] References for Left ventricular aneurysm