Left Ventricular Wall Rupture Research Articles

Abstract 15948: Highly Suspicious Yet Diagnostically Unrevealing Left Ventricular Free-Wall Rupture Following STEMI

Introduction: Left ventricular wall rupture is a rare but lethal complication following a ST elevation myocardial infarction (STEMI). We present a case of left ventricular free-wall rupture not identified on echocardiography and CT angiography (CTA) despite high suspicion who underwent emergent lifesaving mediastinal exploration and repair. Case: A 52-year-old male with past medical history of hypertension presented with typical chest pain. He was found to have STEMI with 100% left anterior descending (LAD) artery occlusion and underwent percutaneous coronary intervention to mid LAD. Post procedure, he developed atrial fibrillation with rapid ventricular rate, pericarditis, increasing pericardial effusion (Figure 1), and cardiogenic shock. He underwent intra-aortic balloon pump placement with no improvement in hemodynamics and subsequently an Impella 5.5 was placed. On post MI Day 3, he underwent pericardial window in the setting of shock and increasing pericardial effusion. Intraoperative TEE showed signs of tamponade physiology (Figure 2). Repeat echocardiograms and CTA was unrevealing of a rupture. Post MI day 6, he had increasing output from the drains and increasing pericardial effusion with complete right ventricular collapse on bedside echocardiogram. Emergent mediastinal exploration revealed left ventricular (LV) free-wall rupture which was repaired with a bovine patch. Hemodynamics improved and goal directed medical therapy was started. Discussion: Free wall rupture is a rare complication post MI and is reported in only 0.01% of STEMI. It usually occurs within 1 week, majority occurring within 24 h of MI. Small LV wall rupture can be challenging to diagnose on cardiac imaging. This case emphasizes the importance of having a high index of suspicion for diagnosing free wall rupture in patients presenting with hemodynamically unstable pericardial effusion post STEMI. Prompt pericardiocentesis and surgical intervention lead to a good outcome.

Takotsubo Syndrome Complicated By Early Left and Right Ventricular Wall Rupture

Takotsubo Syndrome Complicated By Early Left and Right Ventricular Wall Rupture

Cardiac wall rupture in systemic lupus erythematosus: a case report and review of the literature.

Cardiac wall rupture (CWR) is a serious and often fatal complication of myocardial infarction (MI). Despite an increase in the incidence of MI in patients with systemic lupus erythematosus (SLE), cases of CWR in these patients have been reported rarely. This study reports an SLE patient with CWR and pseudoaneurysm formation and reviews previously reported cases of CWR in SLE patients. An English language literature review of from the PubMed, EMBASE, and Scopus databases on published cases of CWR in SLE, up until January 2023, was performed and analyzed. The search identified 4 patients, including the present one, 5 cases altogether. All of them were female aged 27-40years, and 3 of them had had SLE for 10years or more. Chest pain and dyspnea were the common presentations. All had left ventricular (LV) wall rupture. Three patients had LV wall rupture with pseudoaneurysm formation (one had MI with normal coronary artery, one myocardial necrosis secondary from small coronary artery vasculitis and one MI from uncertain cause). The other 2 patients had LV free wall rupture (one had MI with extensive coronary atherosclerosis with coronary arteritis, and the other septic myocarditis with septic coronary arteritis) and these 2 patients died before the diagnosis was made. Three patients with pseudoaneurysm received surgical correction with good clinical outcomes in all. Cardiac wall rupture is a serious and often fatal cardiac complication. Emergency diagnosis and appropriate management with an experienced cardiology team is crucial. Surgical correction is the treatment of choice. Key Points • Cardiac wall rupture, a serious and often fatal cardiac complication, has rarely been described in SLE patients. • Emergency diagnosis and appropriate management with an experienced cardiology team is crucial. Surgical correction is the treatment of choice.

Successfully operated ischemic left ventricular wall rupture in a patient under chronic steroid treatment.

Successfully operated ischemic left ventricular wall rupture in a patient under chronic steroid treatment.

Clinical case of SARS-CoV-2 infection, complicated by the viral pneumonia, the left ventricular wall rupture and the hemorrhagic cardiac tamponade

Clinical case of SARS-CoV-2 infection, complicated by the viral pneumonia, the left ventricular wall rupture and the hemorrhagic cardiac tamponade

Left Ventricular Pseudoaneurysm: A Rare Cause of Chest Pain to Keep in Mind

A man in his 80s presented with sharp central chest pain, diaphoresis, and dyspnea. He had a remote history of coronary artery bypass graft. Results of the physical examination were unremarkable, and initial vital signs were stable. Electrocardiogram was unrevealing. Troponins were elevated and flat. He was initiated on intravenous nitroglycerin, after which his symptoms resolved. However, his blood pressure decreased to a minimal systolic of 76 and diastolic of 50 mm Hg. Because of the resolution of his symptoms, immediate angiography was deferred, and the patient was admitted to the cardiac intensive care unit. Transthoracic echocardiography (TTE) showed a loculated pericardial fluid collection adjacent to the anterolateral left ventricular (LV) wall (Figure; Video 1, available online at http://www.mayoclinicproceedings.org). Contrast TTE showed extension of the contrast from the main LV cavity to the adjacent pericardial cavity, consistent with pseudoaneurysm (Figure; Video 2, available online at http://www.mayoclinicproceedings.org). Computed tomography angiography of the thoracic aorta confirmed LV myocardial rupture along the anterolateral wall with active extravasation of contrast (Supplemental Figure 1A-D, available online at http://www.mayoclinicproceedings.org). The patient’s hospital stay was complicated by acute kidney injury. In the setting of increased risk for dialysis, he opted for conservative management. He remained hemodynamically stable, and pericardiocentesis was not indicated. He was discharged 1 week later. Predismissal TTE redemonstrated the contained LV anterolateral wall rupture with systolic and end-diastolic flow through the myocardial defect (Supplemental Figure 2; Video 3, available online at http://www.mayoclinicproceedings.org). He did well after discharge and died 4 years later of metastatic bladder cancer. Left ventricular pseudoaneurysms develop when LV free-wall rupture is contained by adherent pericardium or scar tissue and is most commonly secondary to myocardial infarction.1Frances C. Romero A. Grady D. Left ventricular pseudoaneurysm.J Am Coll Cardiol. 1998; 32: 557-561https://doi.org/10.1016/s0735-1097(98)00290-3Crossref PubMed Scopus (0) Google Scholar Mortality rate is high both with surgically (23%) and medically (48%) managed patients. Our patient’s previous cardiac surgery was thought to provide him with protection against complete rupture owing to scar tissue formation along the pericardium. The authors have no competing interests. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiIxNTQxZDIwOGFjOGU1NzExNTdlMjNhZjAyYmQzOWFjZiIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjcyMjg1NzkzfQ.bVK6mgeslM0bvj2ghgDzATVaMK2nN-hvkaaOINrhzerjUTY0BhHMM0RiEzxLzEbBfhrwaelJakGbXXQRNll3c1A4XIQPAMOuOb2WwBwZngrk3sZqt9PQ4-QR1521dLqyo87FedzewHEVHQp1u1-hU63njZ80S64gIww7AGwvm1GYVyG_PUqN2dsULzDkhx0u4N5mSlj1ic-GJziWbDQxyp_vNNXowt-C79lK4_irrwGt4gwiXrVTBjmVW7EKxw5UnOPiqxuUal_anvunu52uzNW3lrhjfMSIvZiK_HwBXn1MpYIpEXuY1maXiO04cZRMuJsbkyi_csiLCsenlZMhWQ Download .mp4 (0.63 MB) Help with .mp4 files Supplemental Video 1eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJmNmU1ZDFjYzFjN2ZjM2EwMWM5NDQwZTRiMmVjZTQwMyIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjcyMjg1NzkzfQ.Llq0S-_MHJRqyeGeS8Jl1MGMOD3jHXaMnSq2_kq2VhClHCQx7UQu2w1bavnJDzW-urKRKWcnlXxIP6c8ScTvUdDnqtsubhEVrzHW2JY3Z0uOy9wcg6B_njlmvDJ7DjHkNV_Wg1UShZnAe4D0BMcCn1xyOhNhnmdAmi6V4c4-scHYs1f39hzgdjf9w5F7dKcuSbIKlkrjtEY_qTeY2cR1xdts7_cPrryda-lMKtQI_u3_dJVyf6V98uOfmi83dlBu4IKiMAQTQqVhegEmZZMM2zW5oeMHuoJNa_Aucg2BGVfu0eSp_755fOFZplx8a3eJo6XSzsB117uy6si2bN1Rig Download .mp4 (1.19 MB) Help with .mp4 files Supplemental Video 2Supplemental Figure 2Predismissal transthoracic echocardiography demonstrating contained left ventricular anterolateral wall rupture with systolic flow through the myocardial defect (green arrow).View Large Image Figure ViewerDownload Hi-res image Download (PPT)eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI0ZmEyNTIzYzc5NzdlNjg0NTUzNmI2MDcxMDM2ZTcxNSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjcyMjg1NzkzfQ.CLfwOf7c_tQ5ApbvTOhJiynY9JIChxJ0Ho88bUeccmwEp0wB49X9Fp6UwMS-Qib5WLnv2_nCIlFxES7Q4iG6BIz_EeZA793g_oji_oHVeYoGnFheqPblch42qUSdCpa-xMBwZcZ8c-gzQhvpS3I5zNtDduAhHgYApS4ZAabBZ_mf8tP7br0YwC9bwnbMsA_bSc96LWkKylKVzz_u0U1GrNP9PsBT48qp0Gx1eVFZH__eZ7YuQ8oU67aqRZrGIWmPiVzth5eA72Hj4DjTmNP5QgIm_xzs2b015kbpEQSmn5UIU2iD4DPfCHR1S9woNUB6-DHnncT-Dl6Z2dLsB5WWeA Download .mp4 (0.57 MB) Help with .mp4 files Supplemental Video 3

Early post-septal myectomy outcomes for hypertrophic obstructive cardiomyopathy.

We aimed to evaluate early outcomes of septal myectomy in patients with hypertrophic cardiomyopathy. We retrospectively analyzed data collected over a 9-year period from 583 patients who underwent septal myectomy for hypertrophic cardiomyopathy at our institution. The mean age was 55.7 ± 13.1 years, and 338 (58%) patients were in New York Heart Association class III or IV. There were 11 (1.9%) early deaths, including 3 (0.5%) intraoperative deaths. Early mortality was lowest after isolated septal myectomy (0.8%) and highest after concomitant mitral valve replacement (6.1%). There were 4 (0.7%) and 9 (1.5%) patients with left ventricular wall rupture and ventricular septal defect, respectively, after myectomy. New pacemaker implantation caused by atrioventricular disturbances was required in 29 (5.0%) patients, and was associated with previous alcohol septal ablation (odds ratio 3.34, 95% confidence interval 1.02-11.0, P = 0.047). Left ventricular wall rupture, intraoperative residual (15.5% moderate, 0.3% severe) mitral regurgitation, and pre-discharge residual outflow tract gradient >30 mm Hg (4.6%) occurrences were surgeon-dependent. The early results are consistent with example targets reported in the 2020 American College of Cardiology/American Heart Association guidelines for septal reduction therapy outcomes. Septal myectomy safety and efficacy are surgeon-dependent. Previous alcohol septal ablation increases the risk of permanent pacemaker implantation due to postoperative complete atrioventricular block. Therefore, continuous education, mentoring, and learning by doing may play an important role in achieving reasonable septal myectomy safety and efficacy.

Immediate outcomes of treatment of severe mitral annular calcification

Mitral annular calcification (MAC) is a chronic degenerative process involving the fibrous part of the mitral complex, characterized by calcium deposition and loss of valve function. MAC prevalence is 8–10%, but despite this, the clinical significance of MAC is underestimated. Currently, there are reports that complete decalcification leads to improved long-term outcomes in patients with severe MAC. An analysis of the immediate outcomes of mitral valve surgery in patients with severely calcified mitral annulus with decalcification was performed. The calcified annulus fibrosus underwent complete decalcification in all cases. Calcium deposits were removed in a single block, in 6 cases it was reconstructed with a xeno-pericardial patch; in 2 cases the annulus fibrosus was sutured. There were 2 cases of in-hospital mortality, caused by acute heart failure on day 8 in 1 patient and pulmonary embolism on day 30 after operation in the second patient. There were no complications associated with coronary artery injury and left ventricular posterior wall rupture. Experience in the treatment of severe mitral valve calcification with extensive annulus fibrosus decalcification and subsequent reconstruction is possible and gives satisfactory results.

Coexistent left ventricular clot and self-contained pericardial haematoma: An unusual combination found in a patient post inferior ST-elevation myocardial infarction

The discovery of a left ventricular (LV) thrombus in combination with a pericardial haematoma is a rare occurrence secondary to a complicated myocardial infarction (MI). A 53-year-old male was brought to our emergency in an unresponsive state with unstable haemodynamics. Electrocardiogram showed inferior and right ventricular ST-elevation MI. The patient underwent primary percutaneous coronary intervention of the right coronary and right posterior descending arteries. Echocardiography revealed a mobile clot in the LV apex, secondary to subacute myocardial rupture, and a self-contained pericardial haematoma. Therapeutic subcutaneous enoxaparin was commenced for the LV clot. Changes in the size of the haematoma and LV clot were monitored through serial echocardiographies. The patient underwent an uneventful course where there was gradual dissolution of the clot and resolution of the haematoma. This case illustrates the clinical dilemma of administering anticoagulation for LV clot in the presence of a self-sealed haematoma that could have otherwise resulted in cardiac tamponade and LV wall rupture.

Delayed presentation of acute coronary syndrome with mechanical complication during COVID-19 pandemic: a case report

BackgroundThe World Health Organization declared coronavirus disease 2019 (COVID-19) a global pandemic on 11 March 2020. We report a patient with acute myocardial infarction (AMI) who presented late due to fears of contracting COVID-19.Case summaryA 65-year-old man with a history of hypertension presented late to the emergency department (ED) with AMI. He gave a 2-month history of exertional angina but avoided seeking medical consult due to fears of contracting COVID-19. On the day of admission, he had 4 h of severe chest pain before presenting to the ED. He was hypotensive and tachycardic on arrival. Electrocardiogram showed inferolateral ST-elevation myocardial infarction. Chest radiograph revealed widened superior mediastinum and bedside echocardiogram revealed inferoseptal and inferolateral hypokinesia with features of cardiac tamponade. An urgent computed tomography aortogram showed possible left ventricular (LV) wall perforation with resulting haemopericardium and cardiac tamponade. Subsequent coronary angiogram showed 100% occlusion of mid left circumflex artery and a contained LV wall rupture was confirmed with LV ventriculogram. He was transferred to a tertiary centre and underwent successful emergency surgical repair.DiscussionOur index case demonstrates the impact of the COVID-19 pandemic on health seeking behaviour due to fears of contracting COVID-19 and the ensuing impact of delayed medical intervention. Cardiologists worldwide are seeing an alarming rate of rare complications of AMI in patients who present late. Physicians need to be aware of this phenomenon and have an active role to play in public education.

HEMOPERICARDIUM WITH CARDIAC TAMPONADE DURING AN INFERIOR STEMI DUE TO RUPTURE OF THE LEFT VENTRICULAR WALL: WHERE IS THE CULPRIT LESION?

In this era of PCI, it is important to recognize patients with acute coronary syndrome complicated by left ventricular wall rupture. A 62-year-old woman presented with an acute inferior STEMI and hypotension. Diagnostic coronary angiography revealed 80% stenosis of mid LAD, 70% stenosis of first OM

The evolution of left ventricular pseudoaneurysm from the rupture of left ventricular free wall following acute myocardial infarction: a case report

BackgroundLeft ventricular pseudoaneurysm is a very rare complication following acute myocardial infarction, which results from a free wall rupture. Hemopericardium and cardiac tamponade caused by rupture of the free wall after acute myocardial infarction are often fatal. It is difficult to fully document the evolution of left ventricular pseudoaneurysm resulted from acute myocardial infarction with conservative treatment.Case presentationHerein, we followed a 75-year-old female patient for 3 years. Recorded the evolution of the disease: acute lateral myocardial infarction - emergency reperfusion therapy - cardiac rupture - positive successful rescue - the pseudoaneurysm formation - maintaining conservative treatment - gradual enlargement of the pseudoaneurysm - thrombosis in pseudoaneurysm - thrombus filling with pseudoaneurysm - finally stabilized condition - the treatment of coronary revascularization.ConclusionsThis case is reported here because of its scarcity, which provides provides us with a complete record of the entire evolution and an astonishing indication of the long-term prognosis of non-surgical treatment for pseudoventricular.

The feasibility of robotic-assisted concomitant procedures during mitral valve operations.

In this study, we present our clinical experience and midterm results with the robotic-assisted concomitant procedures during mitral valve operations. Between March 2010 and February 2018, a total of 34 patients (8 males, 26 females; mean age 58.3 years; range, 34 to 78 years) who underwent robotic-assisted concomitant procedures during mitral valve surgery were retrospectively analyzed. Demographic characteristics of the patients, comorbidities, medical, and surgical histories, operative and laboratory results, electrocardiographic findings, postoperative intensive care unit and ward outcomes, and cardiac follow-up data were recorded. Atrial fibrillation-related medication use, stroke, or other thromboembolic events, and electrocardiographic reports in patients who underwent cryoablation were reviewed at three and 12 months after the operation. A total of 76 robotic-assisted concomitant procedures were performed during mitral valve repair (n=11) or replacement (n=23) in 34 patients. These procedures were cryoablation (n=29), tricuspid valve repair (n=6), tricuspid valve replacement (n=2), left atrial appendage ligation (n=32), atrial septal defect and patent foramen ovale closure (n=5), and left atrial thrombectomy (n=2). The mean preoperative EuroSCORE values were 5.1±2.5. The mean duration of cardiopulmonary bypass and cross-clamp was 156±69.4 min and 101±42 min, respectively. Normal sinus rhythm was restored in 85% of the patients (24/28) after cryoablation and two patients (5.8%) had permanent pacemaker within a year during follow-up. There was one (2.9%) mortality in the early postoperative period due to hemorrhage related to the posterior left ventricular wall rupture. No blood product was used in 82.4% of the patients. One patient had a transient cerebral event and symptoms regressed completely within two months. Technological improvements and growing experience can decrease the suspects related to prolonged operational duration during robotic-assisted cardiac surgery. Concomitant procedures in addition to mitral valve operations can be performed with low complication rates in centers with experience of robotic surgery.

Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement \u2013 a retrospective study

BackgroundMitral valve replacement with the total leaflet preservation technique can yield good results; however, its development is limited by patient-valve mismatch. Therefore, we compared the efficacies of the modified total leaflet preservation technique, posterior leaflet preservation technique, and no leaflet preservation technique in mitral valve replacement.MethodsClinical records and echocardiographic data of 180 patients who underwent mitral valve replacement for rheumatic mitral valve disease between 2009 and 2017 were analysed retrospectively to summarise the operative experience and short-term (six months) results. The patients were divided into three groups: group A (n = 62), treated with the modified total leaflet preservation technique; group B (n = 80), treated with the posterior leaflet preservation technique; and group C (n = 38), treated with the no leaflet preservation technique.ResultsNo significant difference in the preoperative clinical data was noted between the groups (p > 0.05). The clamp and recovery times of group A were longer (p < 0.05) and shorter (p < 0.05), respectively, than those of groups B and C. The postoperative left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular ejection fraction of group A were significantly better than those of groups B and C. The incidence of low cardiac output syndrome in group A was lower than that in group C (p < 0.05). There was no postoperative left ventricular posterior wall rupture or mechanical valve dysfunction in group A.ConclusionsThe short-term results of the modified total leaflet preservation technique were better than those of the other techniques. This technique is also suitable for patients with rheumatic mitral valve stenosis.

Spontaneous rupture of left ventricular posterior wall as a complication of mitral valve replacement

In this article, we provided summary of knowledge on left ventricular posterior wall rupture as a complication of mitral valve replacement surgery and shared our experience with such complication.

Mouse Mast Cell Protease 4 Deletion Protects Heart Function and Survival After Permanent Myocardial Infarction.

Chymase, a mast cell serine protease involved in the generation of multiple cardiovascular factors, such as angiotensin II and endothelin-1 (ET-1), is elevated and participates in tissue degeneration after permanent myocardial infarction (PMI). Anesthetized 4-month old male wild-type (WT) C57BL/6J mice and mouse mast cell protease-4 knockout (mMCP-4 KO) congeners were subjected to ligation of the left anterior descending (LAD) coronary artery. A group of mice was then subjected to Kaplan-Meier 28-day survival analysis. In another group of mice, 18F-fluorodeoxyglucose positron emission tomography (PET) was performed to evaluate heart function and the infarcted zone 3 days post-PMI surgery. Cardiac morphology following PMI was evaluated on formalin-fixed heart slices and glycoproteomic analysis was performed using mass spectrometry. Finally, cardiac and lung tissue content of immunoreactive ET-1 was determined. PMI caused 60% mortality in WT mice, due to left ventricular wall rupture, and 7% in mMCP-4 KO mice. Cardiac PET analysis revealed a significant reduction in left ventricular volume (systolic and diastolic) and preserved the ejection fraction in mMCP-4 KO compared to WT animals. The infarcted area, apoptotic signaling and wall remodeling were significantly decreased in mMCP-4 KO mice compared to their WT congeners, while collagen deposition was increased. Glycoproteomic analysis showed an increase in apolipoprotein A1, an established chymase substrate in mMCP-4 KO mice compared to WT mice post-PMI. ET-1 levels were increased in the lungs of WT, but not mMCP-4 KO mice, 24 h post-PMI. Thus, the genetic deletion of mMCP-4 improved survival and heart function post-PMI.

Takotsubo cardiomyopathy: A discussion and case study

Takotsubo cardiomyopathy (TCM), first reported by Japanese doctors, has gained an overall acknowledgment as an independent malady of international attention. It resembles the presentation of an acute myocardial infarction but lacks ischemic myocardial tissue. The objective of this article is to review the physiology, diagnostics, treatment, and complications of TCM and report a case study of a patient who developed TCM. Observation through direct patient care allowed for data collection of this unique medical phenomenon. Supporting information was obtained via investigation of scholarly articles on TCM over the past 10 years. Although TCM is usually transient, it is important to quickly differentiate TCM from other more serious medical conditions, such as myocardial infarction, pulmonary embolism, and pheochromocytoma. Typical diagnostic workup includes electrocardiography, cardiac biomarkers, and echocardiography or coronary angiography. Complications include cardiogenic shock, left ventricular wall rupture, and life-threatening arrhythmias. The advanced practice nurse (APN) is instrumental in differentiating between TCM versus acute myocardial infarction, heart failure, pulmonary edema, dynamic outflow obstruction, and cardiogenic shock. Because of these possible acute and critical presentations, prompt recognition and intervention for patients with TCM are priorities for nurse practitioners.

Erratum: Rupture of the Free Left Ventricular Wall: A Novel Approach for Reconstruction.

[This corrects the article DOI: 10.1055/s-0038-1642613.].

Which strategy should be chosen for ischemic free wall rupture on-pump or off-pump?

In 2017, I reported sutureless repair as a treatment for ischemic heart rupture, and found that an offpump technique using fibrin glue sheets or other materials might contribute to excellent clinical results. In a similar case, Ishii and colleagues reported a patient who underwent sutureless repair with hemostat materials on the bleeding site without cardiopulmonary bypass. Even today, conventional repair under cardiopulmonary bypass leads to unsatisfactory results. A case of a huge pseudoaneurysm after such a repair of left ventricular wall rupture was reported. Although this kind of repair is a simple procedure for ischemic rupture of the left ventricle, clinicians should consider that it carries a potential risk of aneurysmal formation after surgery.

Left Ventricular Contained Rupture: True or Pseudoaneurysm?

AbstractAcute myocardial infarction leading to left ventricular wall rupture is a very lethal complication with the risk of sudden cardiac death. Such contained rupture presents as aneurysmal dilatation of ventricular wall on echocardiography. A false aneurysm is bound by the pericardium without any myocardial tissue and true aneurysm is a bulging of scarred myocardium. Pseudoaneurysm with contained rupture sealed by pericardium needs early surgical intervention. Here, the authors present similar case mimicking as pseudoaneurysm on echocardiography, but it was found out to be true aneurysm as surgical finding.