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Written by Andrea Fields MHA, RDCS

CardioServ Case Study: Name that Pathology!

Patient History

A 67 year old male presents to the ER with complaints of chest pain.

  • EKG showed ST segment elevation in V5/V6

Echo Findings

Apical 2 Echo Pseudoaneurysm

 

Answer: LV Inferior Pseudoaneurysm

Pseudoaneruysms of the left ventricle is a rare complication that results after a myocardial infarction (MI). These aneurysms are localized and contained within the pericardium. Those who are at higher risk for pseudoaneurysms include:

  • Older population
  • Females
  • Hypertension
  • Involve a inferior or lateral wall MI

Echo Findings:

  • They present with a thin/narrow neck that bulges from the ventricular cavity.
  • The segmental wall motion will display either dyskinetic or akinetic, in comparison to the rest of the ventricular myocardium.
  • Pseudoaneurysms can be challenging to diagnosis on TTE and may require other modalities to confirm.

Complications:

  • Pseudoaneurysms have a high mortality rate without surgical intervention.
  • Delayed surgical intervention can increase risk of rupture.
  • The stasis blood within the aneuruysm can cause risk for thrombosis and embolic event.

 

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