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Gupta S, Ankush A, Gandhi P, Gupta V. Cardiac MRI in the diagnosis and management of left ventricular pseudoaneurysms with previous myocardial infarction: A report of two cases. Radiol Case Rep 2024; 19:4242-4247. [PMID: 39135675 PMCID: PMC11318547 DOI: 10.1016/j.radcr.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 08/15/2024] Open
Abstract
A left ventricular pseudoaneurysm, an ominous consequence of acute myocardial infarction, poses a significant threat to patient well-being. Prompt and accurate diagnosis is crucial for improving patient outcomes. This report describes diagnostic imaging findings for identifying left ventricular pseudoaneurysms, emphasizing the critical role of cardiac magnetic resonance imaging alongside other modalities. We present two cases of patients with a history of myocardial infarction who presented with palpitations, chest pain, and shortness of breath. Initial 2D echocardiography in both patients revealed aneurysmal dilation of the left ventricle. Cardiac MRI was then performed, confirming the diagnosis in both cases.
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Affiliation(s)
- Shagun Gupta
- LN Medical College and JK Hospital, Kolar Road, Bhopal, Madhya Pradesh, India
| | - Ankush Ankush
- LN Medical College and JK Hospital, Kolar Road, Bhopal, Madhya Pradesh, India
| | - Prateek Gandhi
- Government Medical College, Near Hanuman Nagar, Nagpur, Maharashtra, India
| | - Vivek Gupta
- LN Medical College and JK Hospital, Kolar Road, Bhopal, Madhya Pradesh, India
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2
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Vaideeswar P, Zare P, Bhatia P. Unusual cardiac aneurysms: a surgical pathology experience. Cardiovasc Pathol 2024; 72:107662. [PMID: 38815840 DOI: 10.1016/j.carpath.2024.107662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024] Open
Abstract
Among the cardiac outpouchings, left ventricular aneurysms or pseudo-aneurysms that develop secondary to myocardial infarctions are the most common. On the other hand, atrial appendageal and valvular aneurysms are uncommon occurrences. The appendageal aneurysms develop possibly due to congenital dysplasia of atrial pectinate muscles, while valvular aneurysms result from infective endocarditis, mechanical injury or degenerative changes. Despite their unusual locations, they are prone to life-threatening complications. We present our experience of unusual cardiac aneurysms in surgical cardiovascular material.
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Affiliation(s)
- Pradeep Vaideeswar
- Department of Pathology (Cardiovascular & Thoracic Division), Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India.
| | - Pranita Zare
- Department of Pathology (Cardiovascular & Thoracic Division), Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Pranav Bhatia
- Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
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3
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Wershing K, Colon J, Alegria J, Paolillo J, Wallihan D, Schwartz M. Left Ventricular Pseudoaneurysm in an Adult With a Repaired Partial Atrioventricular Canal Defect. CASE (PHILADELPHIA, PA.) 2024; 8:174-179. [PMID: 38524982 PMCID: PMC10954580 DOI: 10.1016/j.case.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
•LV pseudoaneurysm formation is rare after congenital heart disease repair. •Conservative management of LV pseudoaneurysm was successful in this unique case. •CCT and 3D printing are valuable in the characterization of LV pseudoaneurysm.
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Affiliation(s)
- Kathryn Wershing
- Department of Pediatrics, Levine Children’s Hospital, Atrium Health, Charlotte, North Carolina
| | - Joseb Colon
- Congenital Cardiac 3D Printing Program, Levine Children’s Hospital, Atrium Health, Charlotte, North Carolina
| | - Jorge Alegria
- Adult Congenital Heart Disease Program, Sanger Heart and Vascular Institute, Atrium Health, Charlotte, North Carolina
| | - Joseph Paolillo
- Adult Congenital Heart Disease Program, Sanger Heart and Vascular Institute, Atrium Health, Charlotte, North Carolina
- Division of Pediatric Cardiology, Levine Children’s Hospital, Atrium Health, Charlotte, North Carolina
| | - Daniel Wallihan
- Division of Radiology, Levine Children’s Hospital, Atrium Health, Charlotte, North Carolina
| | - Matthew Schwartz
- Adult Congenital Heart Disease Program, Sanger Heart and Vascular Institute, Atrium Health, Charlotte, North Carolina
- Division of Pediatric Cardiology, Levine Children’s Hospital, Atrium Health, Charlotte, North Carolina
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Hinton JV, Weinberg L, Fernando D, Yii M. Giant inferobasal left ventricular pseudoaneurysm postinfarction. BMJ Case Rep 2023; 16:e258255. [PMID: 37996134 PMCID: PMC10668128 DOI: 10.1136/bcr-2023-258255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Affiliation(s)
- Jake V Hinton
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Dharsh Fernando
- Department of Cardiology, Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - Michael Yii
- Department of Cardiac Surgery, Epworth Eastern Hospital, Box Hill, Victoria, Australia
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Carolino D'Araujo S, El-Mourad M. Coronary artery compression by left ventricular pseudoaneurysm - clinical case report. Acta Cardiol 2023; 78:961-963. [PMID: 37078592 DOI: 10.1080/00015385.2022.2161741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/16/2022] [Indexed: 04/21/2023]
Affiliation(s)
| | - Mike El-Mourad
- Department of Cardiology, Erasme University Hospital, Brussels, Belgium
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Goh VYS, Yew MS. Multimodality Imaging of an Idiopathic Left Ventricular Aneurysm Presenting With Frequent Premature Ventricular Beats. CASE (PHILADELPHIA, PA.) 2023; 7:377-382. [PMID: 37791125 PMCID: PMC10543177 DOI: 10.1016/j.case.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
•Apical outpouching in the LV may be due to an aneurysm or pseudoaneurysm. •Multimodality imaging is useful for the evaluation of LV outpouching. •An idiopathic LV aneurysm is a rare condition and is a diagnosis of exclusion. •Asymptomatic small LV aneurysm can be treated conservatively.
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Affiliation(s)
| | - Min Sen Yew
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
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Goyal N, Keir G, Esterson YB, Saba SG, Cohen S, Rowin E, Romashko M, Chusid J. Hypertrophic cardiomyopathy - phenotypic variations beyond wall thickness. Clin Imaging 2023; 95:80-89. [PMID: 36680913 DOI: 10.1016/j.clinimag.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy (LVH) in the absence of another causal disease. Several morphologic and histologic changes have been described. Given the morbidity and mortality associated with HCM, understanding these anatomic variations is key to interpreting imaging. This is especially important since many patients exhibit these associated findings in the absence of LVH and prompt early detection of these variations may lead to early diagnosis and treatment. This article describes the appearance of morphologic variations seen in HCM beyond myocardial thickening including: papillary muscle and mitral valve variants, myocardial crypts, left ventricular myocardial bands, and dystrophic calcification related to increased wall tension.
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Affiliation(s)
- Nikhil Goyal
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.
| | - Graham Keir
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA
| | - Yonah B Esterson
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA
| | - Shahryar G Saba
- Department of Cardiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA
| | - Stuart Cohen
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA
| | - Ethan Rowin
- Department of Cardiology, New England Medical Center, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA
| | - Mikhail Romashko
- Department of Cardiology, New England Medical Center, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA
| | - Jesse Chusid
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA
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Zheng Q, Qiao W, Ren W, Xiao Y. Isolated muscular ventricular diverticulum assessment using multi-parameter echocardiographic imaging: Case reports. Echocardiography 2023; 40:289-294. [PMID: 36740936 DOI: 10.1111/echo.15536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/09/2022] [Accepted: 01/20/2023] [Indexed: 02/07/2023] Open
Abstract
Ventricular diverticulum (VDi) is a rare and often asymptomatic congenital cardiac malformation detected incidentally as an outpouching on routine imaging examination, of which the muscular type has been less reported. Here, two patients were incidentally found to have outpouchings of the ventricle during routine transthoracic echocardiography. After a series of multi-parameter echocardiography examination, including two-dimensional (2D), three-dimensional (3D) photo-realistic rendering, blood speckle tracking (BST), and contrast enhancement, to provide morphological structure, spatial relationship, and blood flow information, both cases were finally diagnosed with muscular VDi. These cases highlight the advantages of using multi-parameter echocardiography for the comprehensive assessment of muscular VDi.
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Affiliation(s)
- Qiaojin Zheng
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Qiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weidong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yangjie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
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Ufuk F, Hazirolan T. Cross-sectional imaging findings of cardiac outpouchings. Diagn Interv Radiol 2023; 29:68-79. [PMID: 36960184 PMCID: PMC10679583 DOI: 10.4274/dir.2022.221419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/28/2022] [Indexed: 01/15/2023]
Abstract
A cardiac outpouching (CO) is a protrusion in a heart chamber's internal anatomical lining. Most COs are clinically insignificant, but some are of vital importance, requiring immediate surgery. Cross-sectional imaging findings of COs, such as location, morphology, size, and accompanying wall motion abnormalities, play an essential role in determining the correct diagnosis and appropriate clinical management. Therefore, radiologists should be familiar with them. This article reviews the key cross-sectional imaging findings and differential diagnoses of COs.
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Affiliation(s)
- Furkan Ufuk
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Tuncay Hazirolan
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Cardiac contusions in the acute care setting: Historical background, evaluation and management. Am J Emerg Med 2022; 61:152-157. [PMID: 36116330 DOI: 10.1016/j.ajem.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Albeit described since 1763, cardiac contusions is still an under-recognised clinical condition in the acute care setting. This evidence-based review aims to provide an overview of the topic by focusing on etiopathogenesis, classification and clinical presentation of patients with cardiac contusions, as well as on the diagnostic work-up and therapy options available for this subset population in the acute care setting. METHODS A targeted research strategy was performed using PubMed, MEDLINE, Embase and Cochrane Central databases up to June 2022. The literature search was conducted using the following keywords (in Title and/or Abstract): ("cardiac" OR "heart" OR "myocardial") AND ("contusion"). All available high-quality resources written in English and containing information on epidemiology, etiopathogenesis, clinical findings, diagnosis and management of cardiac contusions were included in our research. RESULTS Biochemical samples of cardiac troponins together with a 12‑lead ECG appear to be sufficient screening tools in hemodynamically stable subjects, while cardiac ultrasound provides a further diagnostic clue for patients with hemodynamic instability or those more likely to have a significant cardiac contusion. CONCLUSIONS The management of patients with suspected cardiac contusion remains a challenge in clinical practice. For this kind of patients a comprehensive diagnostic approach and a prompt emergency response are required, taking into consideration the degree of severity and clinical impairment of associated traumatic injuries.
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Corneliani RT, Tursi M, Spalla I. Advanced imaging findings in a cat with left ventricular apical aneurysm. J Vet Cardiol 2022; 43:55-60. [DOI: 10.1016/j.jvc.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
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Zhang X, Ye RY, Chen XP. Dilated left ventricle with multiple outpouchings — a severe congenital ventricular diverticulum or left-dominant arrhythmogenic cardiomyopathy: A case report. World J Clin Cases 2022; 10:6289-6297. [PMID: 35949831 PMCID: PMC9254184 DOI: 10.12998/wjcc.v10.i18.6289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/20/2022] [Accepted: 04/24/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Left-dominant arrhythmogenic cardiomyopathy (LDAC) is a relatively rare disease characterized by poor prognosis that exacerbates the incidence of sudden cardiac death and ventricular arrhythmias. Clinically, LDAC is constantly overlooked or misdiagnosed as myocardial infarction, myocarditis, and dilated cardiomyopathy, owing to atypical and nonspecific clinical manifestations at an early stage.
CASE SUMMARY A 57-year-old woman was diagnosed with sinus bradycardia and chronic bifascicular block during a health check. She occasionally experienced mild chest pain and paroxysmal palpitation during activity in the past 2 years. Comprehensive auxiliary examinations, including electrocardiogram, echocardiography, coronary computerized tomography angiography, and magnetic resonance imaging, revealed that she had LDAC instead of congenital ventricular diverticulum. The physicians prescribed standard oral therapy for heart failure and implantable cardioverter-defibrillator. Consequently, her left ventricular systolic function and symptoms remained stable at the 2-year follow-up after discharge.
CONCLUSION Based on this case, clinicians need to be aware of LDAC in patients with localized left ventricular lesions and multiple electrocardiographic abnormalities. Multimodality cardiovascular imaging is effective in identification of multiple types of cardiomyopathy and cardiac inner structures.
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Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Run-Yu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Ping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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