%0 Journal Article
%A De Agustín Loeches, José Alberto
%A Fernández Golfín, Covadonga
%A Almería, Carlos
%A Macaya Miguel, Carlos
%A Zamorano Gómez, José Luis
%T Left ventricular pseudoaneurysm expansion without surgical treatment
%D 2012
%@ 2047-2412
%U https://hdl.handle.net/20.500.14352/131930
%X An 82-year-old man was admitted with acute inferior wall myocardial infarction and underwent successful percutaneous coronary intervention for the right coronary artery. Pre-discharge transthoracic echocardiogram revealed a dyskinetic cavity connected to the posterior left ventricular wall (Panel A). Cardiac magnetic resonance confirmed the presence of a pseudoaneurysm with a maximum internal end-systolic dimension of 1.5 × 2 × 1 cm (Panel B). Surgery was strongly recommended to the patient and his family but they declined.One year later the patient was readmitted to the hospital with progressively worsening exertional dyspnoea. Chest X-ray revealed a rounded opacity silhouetting the left cardiac border (Panel C). Echocardiogram showed a great increase in the size of the pseudoaneurysm to ∼7 ×6 ×5 cm, which was communicating with the left ventricle through a 3-cm defect in the posterior left ventricular wall (Panels D and E, Supplementary data online, Video S1). The pseudoaneurysm was contained by a thin layer of visceral pericardium surrounded by thrombotic material in the pericardial space.
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