Radiological features of uncommon aneurysms of the cardiovascular system

Two-Dimensional Transthoracic Echocardiography-Based Diagnosis of Right Ventricular Aneurysm: A Neglected Issue in Patients with Coronary Artery Disease: Case Series and Literature Review

Right ventricular (RV) aneurysm is a very rare ventricular lesion. An aneurysm is formed mainly as a complication of myocardial infarction (MI). As an RV aneurysm is a potentially life-threatening occurrence, its appropriate diagnosis is of great significance. However, right-sided heart diseases, especially RV aneurysms, have been neglected for years. Recent studies in the literature have elucidated the role of the right side of the heart in patients' prognosis and response to treatment. However, RV aneurysm has been scarcely investigated, and most of the attention has been given to the left ventricular aneurysm in patients with ischemic heart diseases (IHD). Herein, we investigated a total of 625 patients with IHD referred for two-dimensional transthoracic echocardiography (2D TTE), among whom 18 were diagnosed with RV aneurysms through precise examination of several TTE views. The characteristics of these cases, including demographics, medical history, and results of cardiac tests (which the patients underwent previously), were recorded and presented. This study emphasized the importance of performing a meticulous 2D TTE evaluation and a thorough examination of different views by an expert echocardiographer, with special attention to the presence of an RV aneurysm in a patient suffering from IHD who presented either with acute coronary syndrome, including MI, or chronic IHD. The scarcity of information, especially in terms of complications and the most appropriate diagnostic methods, calls for further studies in this regard.

A review on the deeper understanding of inflammation and infection of the thoracic aorta

OBJECTIVE

To review the current literature regarding infection and inflammation of the thoracic aorta and to summarise its aetiologies, pathogenesis and clinical presentation. Additionally, the authors sought to compare diagnostic methods and to analyse the different management options.

METHOD

A comprehensive electronic search using PubMed, MEDLINE, Scopus and Google Scholar was conducted to find relevant journal articles with key search terms including: 'aortitis', 'thoracic aortic infection' and 'surgical management of infected thoracic aortic aneurysms'. Prominent publications from 1995 till present (2021) were analysed to achieve a deeper understanding of thoracic aorta infection and inflammation, and the information was then collated to form this review.

RESULTS

The literature review revealed that infectious causes are more prominent than non-infectious causes, with Gram positive bacteria such as Staphylococcus, Enterococcus and Streptococcus accounting for approximately 60% of the infections. The authors also noted that Staphylococcus Aureus was associated with poorer outcomes. Key diagnostic tools include MRI and multi-slice CT imaging, which are useful imaging modalities in defining the extent of the disease thus allowing for planning surgical intervention. Surgical intervention itself is extremely multifaceted and the rarity of the condition means no large-scale comparative research between all the management options exists. Until more large-scale comparative data becomes available to guide treatment, the optimal approach must be decided on a case-by-case basis, considering the benefits and drawback of each treatment option.

CONCLUSION

A high index of suspicion and a comprehensive history is required to effectively diagnose and manage infection and inflammation of the thoracic aorta. Differentiating between infectious and inflammatory cases is crucial for management planning, as infectious causes typically require antibiotics and surgical intervention. Over the years, the post treatment results have shown significant improvement due to earlier diagnosis, advancement in surgical options and increasingly specific microbial therapy.

Incidental Left Ventricular Aneurysm Discovered after Chest Pain Following a Motor Vehicle Collision

We report the case of a female with a history of coronary artery disease who came in with chest pain after a motor vehicle collision. Imaging revealed an incidental left ventricular aneurysm. The presentation and management of left ventricular aneurysms are discussed, along with imaging findings on computed tomography, plain radiography, and ultrasonography.

A Sensible Approach to Diagnosing Cardiac Aneurysms, Pseudoaneurysms and Common Mimickers

The heart can manifest a spectrum of focal convexities that range from insignificant crypts and diverticula to clinically relevant aneurysms and pseudoaneurysms. The distinction of a clinically significant lesion from a minor focal convexity can be challenging. This article outlines the various types of focal convexities on the basis of location within the heart and discusses unique morphologic and functional features to further characterize these entities. We also highlight the most critical clinical consequences of cardiac aneurysms and pseudoaneurysms such as thromboembolic events, aneurysm ruptures, intracardiac shunting, hemopericardium, and arrhythmias.

Ductal aneurysm with postsubclavian coarctation of aorta in an adult

We describe a case of ductal aneurysm in an adult patient with post subclavian coarctation of aorta, which is a very rare association.