Calcified left ventricular apical aneurysm with intramural thrombus – A case report
Dean M Nelson, Anthony P Brennan, Jaishankar Raman, Andrew T Burns- Cardiology and Cardiovascular Medicine
Abstract
Background
Left ventricular aneurysms (LVAs) are a well appreciated complication of acute myocardial infarction. Ventricular aneurysms involving the left ventricle (LV) typically evolve as a result of anterior myocardial infarction, and are associated with greater morbidity, complication rates and hospital resource utilisation. Incidence of LVA is decreasing with advent of modern reperfusion therapies, however in the setting of excess morbidity, clinicians must maintain an appreciation for their appearance to allow timely diagnosis and individualised care.
Case Summary
This case report describes the clinical history, investigation, appearance, and management of a patient with calcified apical LVA with history of previous anterior ST-elevation myocardial infarction. The patient was initially admitted for elective coronary angiography in the setting of worsening exertional dyspnoea, and subsequently underwent coronary artery bypass grafting (CABG), aneurysm resection and LV reconstruction.
Discussion
LVAs are an uncommon complication experienced in the modern era of acute myocardial infarction and current reperfusion therapies, however remain an important cause of excess morbidity and complication. Evidence based guidelines for the diagnosis, workup, and subsequent management of LVAs are lacking. The imaging findings presented in this case serves as an important reminder of the appearance of LVAs, so that timely diagnosis and individualised care considerations can be made.