Nagpal Prashant, Saboo Sachin S, Khandelwal Ashish, Duran-Mendicuti Maria Alejandra, Abbara Suhny, Steigner Michael L
1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA ; 2 Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA ; 3 Department of Radiology, Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, TX, USA.
Cardiovasc Diagn Ther. 2015 Apr;5(2):141-4. doi: 10.3978/j.issn.2223-3652.2015.01.04.
Pseudoaneurysm is defined as contained blood pooling due to rupture of vascular wall. They have higher risk of rupture and hence are usually managed aggressively. Trauma, infection and prior surgery are the most common etiologies for pseudoaneurysm of most sites. Traumatic cardiac pseudoaneurysm are rare and poses a diagnostic challenge to the treating physician since there is no specific symptoms associated with pseudoaneurysm and electrocardiogram; cardiac enzymes and echocardiogram may be unrevealing or inconclusive in many cases. Cross-sectional imaging [computed tomography (CT) and magnetic resonance imaging (MRI)] is done in cases with high index of suspicion and is the standard modality for diagnosis for cardiac pseudoaneurysm. We present a case of conservatively managed post-traumatic right atrial pseudoaneurysm with aim to highlight the role of electrocardiography (ECG)-gated multidetector computed tomography (MDCT) in diagnosis and follow-up of this rare entity that ultimately underwent rapid partial thrombosis.
假性动脉瘤被定义为由于血管壁破裂而形成的局限性血液聚集。它们破裂的风险较高,因此通常需要积极处理。创伤、感染和既往手术是大多数部位假性动脉瘤最常见的病因。创伤性心脏假性动脉瘤较为罕见,给治疗医生带来诊断挑战,因为假性动脉瘤没有特异性症状,而且心电图、心肌酶和超声心动图在很多情况下可能无异常发现或结果不明确。对于高度怀疑的病例,会进行横断面成像检查[计算机断层扫描(CT)和磁共振成像(MRI)],这是诊断心脏假性动脉瘤的标准方法。我们报告一例保守治疗的创伤后右心房假性动脉瘤病例,旨在强调心电图(ECG)门控多层螺旋计算机断层扫描(MDCT)在诊断和随访这种罕见疾病中的作用,该病例最终迅速发生部分血栓形成。