Uncommon post-infarction pseudoaneurysms: A case report |
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Authors: | Hamid Jallal Soufiane Belabes Ali Khatouri |
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Affiliation: | Hamid Jallal, Department of Cardiology, Military Hospital of Instruction Omar Bongo Ondimba, Libreville 204040, GabonSoufiane Belabes, Department of Radiology, Military Hospital of Instruction Omar Bongo Ondimba, Libreville 20404, GabonAli Khatouri, Department of Cardiology, Military Hospital Avicenne, University Cadi Ayyad, Marrakech 40000, Morocco |
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Abstract: | BACKGROUNDMechanical complications are a rare presentation in chronic coronary syndromes, which have significantly decreased in the primary coronary intervention era. Incomplete rupture may occur, resulting in pseudoaneurysms (PANs). Early reperfusion decreases the risk of this complication. Echocardiography is the method of choice for diagnosis.CASE SUMMARYA 54-year-old female hypertensive patient, with a history of non-revascularized inferior and anterior ST-segment elevation myocardial infarction (MI) 4 years prior, was admitted to the cardiac unit of the hospital with complaints of abdominal pain and dyspnea lasting 2 mo. The patient was hemodynamically stable, and 12-lead electrocardiogram showed persistent ST elevation and Q wave in the inferior and apical regions. Transthoracic echocardiogram in the two-chamber view showed a narrow neck of a wide PAN in the distal apical left ventricular inferior wall. In addition, the apical four-chamber and subcostal views revealed a second bulky PAN of the apical wall separated from the first by a common organizing thrombus. Cardiac magnetic resonance imaging confirmed the coexistence of more than one PAN. The patient received conservative medical treatment, and surgery was scheduled for outside the country. The patient had worsening multiple organ failure and died 4 wk after presentation.CONCLUSIONMultifocal PANs rarely occur in chronic MI. Attention should be paid to patients with pain and cardiovascular risk factors. |
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Keywords: | Cardiac rupture Myocardial infarction Pseudoaneurysm Echocardiogram Case report |
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