Inferior wall ventricular aneurysm: a rare late complication of myocardial infarction. Importance of timely diagnosis
Keywords:
Left ventricular aneurysm, myocardial infarction, ventricular tachycardia, echocardiogram.Abstract
Introduction: Ventricular aneurysm presents as a late mechanical complication of Acute Myocardial Infarction; it is generally reserved to designate an isolated dyskinetic area of the left ventricular wall with a wide neck. The incidence of an inferior-posterior or lateral wall aneurysm is very low, approximately 5% to 10%. This entity increases the risk of mortality, even when compared to that of patients with similar left ventricle ejection fraction.
Objective: To establish the importance of the timely diagnosis of a rare and late complication of acute myocardial infarction.
Case presentation: A patient with history of acute inferior myocardial infarction and episodes of recurrent ventricular tachycardia with an echocardiographic diagnosis of a large aneurysm in the inferior and lateral wall with thrombi inside is described in this paper. Medical treatment was optimized, and an implantable cardioverter-defibrillator was indicated.
Conclusions: The presence of a true ventricular aneurysm in the infero-lateral wall is a rare late complication of acute myocardial infarction; ventricular tachycardia is one of the forms of presentation of this entity. Regular follow-up of the patient after the event leads to timely diagnosis and appropriate treatment.Downloads
References
1. Bennour E, Sghaier A, Jemel A, Laroussi L, Ikram K, Marrakchi S, et al. A giant calcified aneurysm of the basal inferior wall: a rare phenomenon. Pan Afr Med J [Internet]. 2020 [Citado 28/01/2022];29(37):193. Disponible en: https://www.panafrican-med-journal.com//content/article/37/193/full
2. Scirica B, Libby P, Morrow D. ST-Elevation Myocardial Infarction: Pathophysiology and Clinical Evolution. En: Libby P, Braunwald E, eds. Braunwald’s Heart Disease: a textbook of cardiovascular medicine. 12 ed [Internet]. Philadelphia; Elsevier; 2021. pp. 636-713 [Citado 28/01/2022]. Disponible en: https://www.elsevier.com
3. Patel P, Siegenthaler M, Bandettini WP, Arai AE, Fujikura K. Left Ventricular Pseudoaneurysm in a Patient with an Apical Aneurysm. JACC Case Rep [Internet]. 2020 [Citado 28/01/2022];3(1):91-3. Disponible en: https://doi.org/10.1016/j.jaccas.2020.05.088
4. Instituto Secretaria de Salud. Diagnóstico y Tratamiento del aneurisma Ventricular. Catálogo maestro de guías de práctica clínica: IMSS-464-11 [Internet]. México: Instituto Secretaria de Salud; 2011 [Citado 28/01/2022]. Disponible en: https://www.imss.gob.mx
5. Delcán JL, Serrano J, Pérez N, Osende J, Cantalapiedra J, Fuentes M, et al. Cardiopatía Isquémica. En: Delcán JL, ed. Infarto agudo de miocardio: clínica, evolución y complicaciones. Madrid: Sociedad Española de Cardiología; 1999. pp. 1041-55.
6. Sattar Y, Alraies M. Ventricular Aneurysm [Internet]. Treasure land: StatPearls Publishing; 2022 [Citado 28/01/2022]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK555955/
7. Cabrera-Rego J, Castañeda O, Valiente-Mustelier J, LLerena-Rojas R, López-Ferrero L, Mendoza-Rodríguez V. Presentación tardía de aneurisma ventricular post-infarto. Caracterización por múltiples modalidades de imagen. Revista Finlay [Internet]. 2011 [Citado 27/02/2020];1(3):[Aprox. 5 p.]. Disponible en: http://www.revfinlay.sld.cu/index.php/finlay/article/view/57
8. Sánchez-Montaño M, Verdugo-Rosas A, Quiroz-Beltrán LI, Herrera-Sánchez A. Aneurisma ventricular izquierdo gigante, visión del médico radiólogo: Reporte de caso. Revista Médica MD. 2016;8(1):25-8.
9. Gong FF, Vaitenas I, Malaisrie SC, Maganti K. Mechanical Complications of Acute Myocardial Infarction: A Review. JAMA Cardiol. 2021;6(3):341-9.
10. Gil L, Estévez F, Acosta F, Perea C, Iturralde L, Cattáneo J. Aneurisma ventricular izquierdo asociado a trombo mural: una complicación poco frecuente del IAMCEST. Rev Conarec [Internet]. 2020 [Citado 28/01/2022];35(156):265-7. Disponible en: http://www.revistaconarec.com.ar
11. Sui Y, Teng S, Qian J, Zhao Z, Zhang Q, Wu Y. Treatment outcomes and therapeutic evaluations of patients with left ventricular aneurysm. J Int Med Res [Internet]. 2019 [Citado 28/01/2022];47(1):244-51. Disponible en: https://pubmed.ncbi.nlm.nih.gov
Download PDF
