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Left Ventricular Pseudoaneurysm: Title and subTitle BreakIts Recognition and Significance FREE

Abraham H. Dachman, MD; Hugo Spindola-Franco, MD; Norman Solomon, MD
[+] Author Affiliations

Reprint requests to Department of Radiology, Montefiore Hospital and Medical Center, 111 E 210th St, Bronx, NY 10467 (Dr Spindola-Franco).


JAMA. 1981;246(17):1951-1953. doi:10.1001/jama.1981.03320170063036
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CARDIAC rupture is a major cause of mortality after myocardial infarction.1,2 In a small percentage of patients, cardiac rupture is not a catastrophic event, but, rather, results in the formation of a pseudoaneurysm. Pseudoaneurysm is the result of ventricular rupture contained by adherent pericardium and fibrotic tissue. Pseudoaneurysm is thus characterized by the absence of myocardial tissue in its wall and a relatively narrow ostium between the ventricle and the paraventricular chamber (Fig 1).

The plain-film finding of a paracardiac mass in a diaphragmatic or posterolateral location (Fig 2) in conjunction with a history of previous myocardial infarction is highly suggestive of pseudoaneurysm and is sufficient indication for angiographic studies.3,4 Left ventriculography will show a paraventricular chamber filling via a relatively narrow ostium. The diagnosis is confirmed by demonstrating an avascular wall on coronary arteriography.4

Report of a Case  A 62-year-old man was admitted for syncope and

REFERENCES

Van Tassel RA, Edwards JE:  Rupture of heart complicating myocardial infarction: Analysis of 40 cases including nine examples of left ventricular false aneurysm . Chest 1972;;61:104-116.
Bates EJ, Beutler S, Resnekov L, et al:  Cardiac rupture—challenge in diagnosis and management . Am J Cardiol 1977;;40:429-437.
Higgins CB, Lipton MJ, Johnson AD, et al:  False aneurysm of the left ventricle: Identification of distinctive clinical, radiographic, and angiographic features . Radiology 1978;;127:21-27.
Spindola-Franco H, Kronacher N:  Pseudoaneurysm of the left ventricle: Radiographic and angiocardiographic diagnosis . Radiology 1978;; 127:29-34.
Spindola-Franco H, Adams DF, Herman MV, et al:  Reciprocating flow in the coronary circulation . Radiology 1973;;107:497-504.
Bjornsson L:  Pseudoaneurysm of the left ventricle of the heart: A rare complication of myocardial rupture following infarction—report of a case . Am J Clin Pathol 1964;;41:302-306.
Chesler E, Korns ME, Sember T, et al:  False aneurysms of the left ventricle following myocardial infarction . Am J Cardiol 1969;;23:76-82.
Schlichter J, Hellerstein HK, Katz LN:  Aneurysm of the heart: A correlative study of 102 proved cases . Medicine 1954;;33:43-86.
Grondin P, Kretz JG, Bical O, et al:  Natural history of saccular aneurysms of the left ventricle . J Thorac Cardiovasc Surg 1979;;77:65-75.
Roelandt J, Vanden Brand M, Vletter WB, et al:  Echocardiographic diagnosis of pseudoaneurysm of the left ventricle . Circulation 1975;; 52:466-472.
Botvinick EH, Shames D, Hutchinson JC, et al:  Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac pool imaging: Differentiation from true aneurysm . Am J Cardiol 1976;;37:1089-1093.
Davila JC, Enriquez F, Bergoglio S, et al:  Congenital aneurysm of the left ventricle . Ann Thorac Surg 1965;;1:697-710.

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Van Tassel RA, Edwards JE:  Rupture of heart complicating myocardial infarction: Analysis of 40 cases including nine examples of left ventricular false aneurysm . Chest 1972;;61:104-116.
Bates EJ, Beutler S, Resnekov L, et al:  Cardiac rupture—challenge in diagnosis and management . Am J Cardiol 1977;;40:429-437.
Higgins CB, Lipton MJ, Johnson AD, et al:  False aneurysm of the left ventricle: Identification of distinctive clinical, radiographic, and angiographic features . Radiology 1978;;127:21-27.
Spindola-Franco H, Kronacher N:  Pseudoaneurysm of the left ventricle: Radiographic and angiocardiographic diagnosis . Radiology 1978;; 127:29-34.
Spindola-Franco H, Adams DF, Herman MV, et al:  Reciprocating flow in the coronary circulation . Radiology 1973;;107:497-504.
Bjornsson L:  Pseudoaneurysm of the left ventricle of the heart: A rare complication of myocardial rupture following infarction—report of a case . Am J Clin Pathol 1964;;41:302-306.
Chesler E, Korns ME, Sember T, et al:  False aneurysms of the left ventricle following myocardial infarction . Am J Cardiol 1969;;23:76-82.
Schlichter J, Hellerstein HK, Katz LN:  Aneurysm of the heart: A correlative study of 102 proved cases . Medicine 1954;;33:43-86.
Grondin P, Kretz JG, Bical O, et al:  Natural history of saccular aneurysms of the left ventricle . J Thorac Cardiovasc Surg 1979;;77:65-75.
Roelandt J, Vanden Brand M, Vletter WB, et al:  Echocardiographic diagnosis of pseudoaneurysm of the left ventricle . Circulation 1975;; 52:466-472.
Botvinick EH, Shames D, Hutchinson JC, et al:  Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac pool imaging: Differentiation from true aneurysm . Am J Cardiol 1976;;37:1089-1093.
Davila JC, Enriquez F, Bergoglio S, et al:  Congenital aneurysm of the left ventricle . Ann Thorac Surg 1965;;1:697-710.
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