EComment. Left ventricle pseudoaneurysm secondary to infective endocarditis

Abstract

In the interesting case report presented by Singh et al. [1], the patient underwent a successful aneurysmorrhaphy four months after a blunt non-penetrating chest injury. What is remarkable in their report is that the authors make no allusion in their discussion to a previous and well-known aetiology of left ventricle pseudoaneurysm which is infective endocarditis. We [2] and others [3] have published case reports about false aneurysm arising from the left ventricle in patients with infective endocarditis. Myocardial abscess, pseudoaneurysm of the ventricle and cardiac rupture rarely complicate infective endocarditis. Presentation can vary from pericardial effusion to cardiac tamponade occurring in association with annular abscess or myocardial perforation [4]. Formation of a myocardial abscess may be secondary to multiple coronary septic emboli or to local spread from the infected endocardium to the nearby myocardium. Rupture of the myocardial abscess is often fatal, but when the rupture is contained by scar tissue, this entity is known as a post-infective endocarditis pseudoaneurysm. As long as the pseudoaneurysm remains contained, the haemodynamic state will remain good but the chances of survival without surgery remain slim [5]. Conflict of Interest: None declared