Jiang Chaohui, Zhao Rong, Yang Xziangjun
Department of Cardiology, Shanghai Ninth Hospital, Jiao Tong University School of Medicine, Shanghai, China.
Can J Cardiol. 2007 Jul;23(9):739-41. doi: 10.1016/s0828-282x(07)70821-8.
Pseudoaneurysm of the left ventricle is a rare complication of acute myocardial infarction. The present report describes the unusual case of a 75-year-old woman who survived six years with an unrepaired left ventricular pseudoaneurysm. The diagnosis of pseudoaneurysm was made after two-dimensional echocardiography showed an extra large chamber next to the posterolateral region of the left ventricle with a massive thrombus; the diagnosis was confirmed by magnetic resonance imaging four years later. The patient refused surgical repair and continued with acetylsalicylic acid, a beta-blocker and an angiotensin II receptor antagonist. The patient was essentially asymptomatic and followed at six-month intervals until she died of carcinoma of the urinary bladder in the sixth year. The present case indicates that surgery is not the only therapeutic option in patients with a ventricular pseudoaneurysm.
左心室假性动脉瘤是急性心肌梗死的一种罕见并发症。本报告描述了一名75岁女性的罕见病例，她未修复左心室假性动脉瘤存活了六年。二维超声心动图显示左心室后外侧区域旁有一个超大腔室且伴有大量血栓后，作出了假性动脉瘤的诊断；四年后磁共振成像证实了该诊断。患者拒绝手术修复，继续服用阿司匹林、β受体阻滞剂和血管紧张素II受体拮抗剂。患者基本无症状，每六个月随访一次，直到第六年死于膀胱癌。本病例表明，手术并非心室假性动脉瘤患者的唯一治疗选择。
