Left ventricular pseudoaneurysm

Background

• LV Pseudoaneurysm = acute MI causes ventricular free wall rupture that is contained by pericardial adhesions
  • Only small ones compatible with life

Causes

• Transmural MI (anterior most common)

Clinical Features

• Can be asymptomatic
• Hx of MI
• Angina, SOB/DOE

Differential Diagnosis

• Left Ventricular Aneurysm

Diagnosis

• LV angiography (TTE unreliable)

Treatment

• Surgical repair = 10% 5 yr mortality
• Medical therapy = 50% 5 yr mortality

Complications

• Angina (increased O2 demand)
• Complete LV rupture