Case Of Left Ventricular Aneurysm Research Articles

Characteristics and outcomes of fetal ventricular aneurysm and diverticulum: combining the use of a new technique, fetal HQ.

Congenital ventricular aneurysms or diverticulum (VA/VD) are rare cardiac anomalies with lack prenatal evaluation data. The present study aimed to provide the prenatal characteristics and outcomes from a tertiary center and the use of new techniques to evaluate the shape and contractility of these fetuses. Ten fetuses were diagnosed with VA or VD, and 30 control fetuses were enrolled. Fetal echocardiography was performed to make the diagnosis. The prenatal echo characteristics and follow-up data were carefully reviewed. The shape and contractility measurements of the four-chamber view (4CV) and both ventricles were measured and computed using fetal fetal heart quantification (HQ). A total of 10 fetuses were enrolled, including 4 cases of left ventricular diverticulum, 5 cases of left ventricular aneurysm, and 1 case of right ventricular aneurysm (RVA). Four cases chose to terminate the pregnancy. The RVA was associated with a perimembranous ventricular septal defect. Two cases had fetal arrhythmia, and one case had pericardial effusion. After birth, one case underwent surgical resection at five years old. The 4CV global sphericity index (SI) of free-wall located ventricular outpouching (VO) was significantly lower than the apical ones and the control group (p < 0.01). Four of five apical left VOs had significant higher (>95th centile) SI in base segments, and three of four left VOs in the free-wall had significant lower (< 5th centile) SI in the majority of 24 segments. Compared to the control group, the left ventricle (LV) global longitudinal strain, ejection fraction, and fractional area change were significantly decreased (p < 0.01), while the LV cardiac output of the cases was in the normal range. The transverse fraction shortening of the affected segments of ventricles was significantly lower than the other ventricle segments (p < 0.01). Fetal HQ is a promising technique to evaluate the shape and contractility of congenital ventricular aneurysm and diverticulum.

Congenital cardiac left ventricular aneurysm revealed by a hydrops foetalis

Prenatal detection of fetal left ventricular aneurysm is rare condition defined by a unilobulated or multilobulated bulging of a ventricular wall segment. The clinical profile, natural course, and treatment remain unclear because these malformations are rare. In view of their infrequency, it would be interesting to report cases in order to have more data concerning the diagnosis, the prognosis and the management. We present a case of left ventricular aneurysm with a hydrops foetalis diagnosed at 21 weeks’ gestation in a 23-year-old primiparous woman who was referred for routine screening ultrasonography. A fetal echocardiogram showed an abnormal four-chambers view with a large cystic lesion on the anterolateral wall of the left ventricle. We found a severe left ventricular dysfunction with a severe mitral regurgitation with an hydrops foetalis with a pericardial effusion, large volume septate ascite and a bilateral pleural effusion. Fetal MRI, in T2 Trufi sequences (axial, coronal and sagittal sections), shows a large segment of the apical left ventricular wall that exhibited a thin-walled outpouching with a wide communication to the left ventricular cavity ( Fig. 1 ). Congenital LV aneurysms (LVA) are rare and poorly understood. Twenty-six reported cases were published until 2014 ( Fig. 2 ). The differential diagnosis is congenital left ventricular diverticula. The prognosis of congenital left ventricular aneurysms is quite variable, depending on size, growth over time, the presence or absence of compression of the fetal lung and signs of cardiac failure.

Four-dimensional echocardiographic and pathologic findings of congenital left ventricular aneurysm: A case report.

The sonographic and histopathologic features of a rare case of left ventricular aneurysm are reported, detailing the method of prenatal diagnosis and suggesting possible etiology of congenital ventricular aneurysm.

Left apical aneurysm in a patient with severe aortic valve stenosis.

We report on a very rare case of left ventricular aneurysm in a 77-year-old patient with aortic valve stenosis and without coronary artery disease. The patient underwent conventional aortic valve replacement and left ventricular aneurysmectomy with an uneventful postoperative course. The cause of the left ventricular aneurysm was suspected to be a long history of aortic valve stenosis that led to severe intraventricular hypertension, subsequently asymmetric septum hypertrophy, and finally apical aneurysm.

A case of left ventricular aneurysm caused by localized myocardial infarction.

A 73-year-old man was hospitalized for unstable angina pectoris with no history of myocardial infarction. After undergoing percutaneous coronary intervention, left ventriculography incidentally revealed a cavity in the anterior wall, and echocardiography found the cavity wall to be dyskinetic. Myocardial contrast echocardiography revealed that the wall of the cavity was surrounded by myocardial tissue with low perfusion. Furthermore, radial strain in the wall of the cavity was low. Myocardial scintigraphy showed a localized defect on the anterior wall. The patient was finally diagnosed as true aneurysm after asymptomatic and localized myocardial infarction, and has since been followed up by echocardiography in the outpatient clinic.

Post-Traumatic Coronary Occlusion and Left Ventricular Aneurysm

Left ventricular aneurysm is a rare complication of blunt chest trauma. We now report a case of left ventricular aneurysm following blunt chest trauma associated with an acute coronary occlusion.

Calcified Left Ventricular Aneurysm: “An Egg in the Heart”

We present a peculiar case of left ventricular aneurysm which had calcified over 14 years post anterior myocardial infarction and appears to be like an egg in the heart. Previous cases reported of calcified LV ring were associated with Left Ventricular mural thrombus. In our patient, we did not identify any mural thrombus.

Evaluation of congenital left ventricular aneurysm in the fetus by velocity vector imaging.

We report a case of left ventricular aneurysm evaluated using the velocity vector imaging (VVI) technique, an angle-independent method used to calculate the tissue velocity strain and strain rate on routine gray scale two-dimensional images and display the velocities of endocardial points as vectors overlaid on B-mode images. It uses a combination of speckle tracking and complex geometric analysis, allowing tracing of myocardial activity throughout the cardiac cycle. In this case, evaluation of the myocardial dynamics in the fetus by VVI was started at 27weeks of gestation, and both the systolic and diastolic velocities and the ejection fraction in the aneurysmal segment were less than in the other segments. VVI imaging at 35weeks of gestation showed this difference even more clearly. Postnatal VVI examination showed no significant difference between results for the systolic and diastolic velocities or ejection fraction and those obtained at the prenatal VVI examination. VVI seemed to be as useful at this time, especially for assessing ventricular systolic function, as it was for postnatal examination.

Congenital Cardiac Left Ventricular Aneurysm With Pericardial Effusion

Congenital left ventricular aneurysm is a rare condition characterized by a protrusion or outpouching of the ventricular wall. The etiology is unknown, and there is a variable prognosis in the current literature. Approximately 20 cases detected by prenatal ultrasonography have been reported, 1 - 1 2 with 4 of these cases indicating the presence of pericardial fluid. 1 , 1 0 , 1 1 We report a case of left ventricular aneurysm with a large pericardial effusion diagnosed at 17 weeks' gestation but retrospectively recognized on imaging at 15 weeks 6 days. To our knowledge, this represents the earliest reported prenatal diagnosis to date and newly reports placement of a pericardial drain catheter in this condition.

Imaging for the Diagnosis of an Unusual Case of Left Ventricular Aneurysm

An isolated ventricular diverticulum in an adult patient investigated for chest pain is reported. An exhaustive diagnosis was obtained by different means and complementary imaging techniques such as echocardiography, cardiovascular magnetic resonance imaging and cineangiography.

Prenatal diagnosis of left ventricular aneurysm: a report of three cases and a review.

We report three cases of left ventricular aneurysm diagnosed prenatally and followed by fetal Doppler echocardiography. A review of the literature reveals a paucity of information about this rare cardiac malformation. Most of the described cases (6 out of 9) have remained asymptomatic during pregnancy and after birth. Our cases, in contrast, and three others in the literature, had an ominous prognosis presenting cardiac failure initially or during follow up and showing a dynamic evolution of the aneurysm. Cross-sectional echocardiography provides the diagnosis, revealing the thin-walled aneurysm, usually apical, to be connected by a broad neck to the left ventricle. Color and pulsed Doppler shows low velocity and to-and-fro flow in the aneurysm. Sequential fetal Doppler echocardiography detects the potential growth of the aneurysm relative to ventricular size, revealing any compromise of cardiac performance by a decreased mitral opening, reversed atrial shunting, a hypokinetic infero-posterior left ventricular wall, and a poor systolic thickening of the wall of the aneurysm. Compromise of cardiac function, and deleterious impact on development of the lungs during fetal life, may depend on the early onset, growth and location of the aneurysm,which may occupy most of the fetal chest. We discuss issues of prenatal diagnosis, sequential surveillance of the natural history, and factors of prognosis as well as myocardial histological data from one of our cases.

Coxsackie B4 viral myocarditis causing ventricular aneurysm

This report describes a patient with viral myocarditis who developed acute dilated cardiomyopathy. The patient recovered well but a left ventricular aneurysm was detected angiographically. There was no history of myocardial infarction and the coronary arteries were normal. This is the first reported case of left ventricular aneurysm due to viral myocarditis.

A case of left ventricular aneurysm of uncertain etiology presenting as ventricular tachycardia

A case of a 59-year-old Asian male with several episodes of syncope and palpitation is reported. Electrophysiologic study disclosed that sustained ventricular tachycardia was induced by programmed electrical stimulation at the right ventricular apex. The electrogram in the left ventricular aneurysm showed delayed activities and the fastest depolarization. Entrainment was observed by faster pacing. Left ventriculography showed a large aneurysm and normal coronary arteries. Congenital left ventricular aneurysm is the most likely clinical diagnosis given the lack of past history of chest pain, myocarditis, cardiomyopathy, etc. Congenital aneurysm which presents as ventricular tachycardia is very rare, and has never been reported in an Asian. Medical management has thus far been successful.

Aneurysmectomy for symptomatic supraventricular tachycardia associated with ventricular aneurysm.

A case of left ventricular aneurysm associated with repeated supraventricular tachyarrhythmias was successfully treated by ventricular aneurysmectomy. Ventricular aneurysmectomy should be considered for supraventricular tachyarrhythmia as well as ventricular tachycardia, if they are symptomatic and refractory to medical therapy.

Roentgen diagnosis of left ventricular aneurysm.

ROENTGEN DIAGNOSIS OF LEFT VENTRICULAR ANEURYSMLARS BJÖRK, M.D.Audio Available | Share

ANEURYSM OF THE LEFT VENTRICLE FOLLOWING CORONARY INFARCT IN LIVING PATIENT

In 1903, D. G. Hall,1reviewing 112 cases of aneurysms of the heart, found post mortem, said: Aneurysms of the heart must necessarily be of interest rather to the pathologist than to the clinician, for they are outside of the pale of practical diagnosis. He reported that, among the 112 cases of aneurysms of the heart, there were 92 of the left ventricle, over 60 per cent of these being at or near the apex of the heart. These were due to coronary occlusion that occurred between the ages of 40 and 70. Seventy-four per cent were in males and 32 of the 112 died suddenly. More recent reports on aneurysms of the left ventricle show statistics similar to Hall's. Cases of left ventricular aneurysm, diagnosed ante mortem by the fluoroscope and x-rays, and substantiated at autopsy, have been reported by Lutembacher (two cases),2Heitz and Corone3