Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL.
Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL; Miami Veteran's Health Administration, Miami, FL.
J Cardiothorac Vasc Anesth. 2019 Aug;33(8):2344-2348. doi: 10.1053/j.jvca.2019.01.016. Epub 2019 Jan 4.
True left ventricular aneurysms are most frequently seen after acute transmural myocardial infarction. These aneurysms are distinct from apical left ventricular pseudoaneurysms, which can also be seen in ischemia, and have a different treatment course. A major dilemma for clinicians is using echocardiographic information to make this distinction. Coronary angiography aids in this distinction; however, in the case of normal coronaries alternate etiologies must be considered. The differential for a patient with a left ventricular aneurysm and normal coronaries or no prior cardiac surgery is broad and includes traumatic, infectious and infiltrative causes. In this e-challenge, we present an unusual cause of a left ventricular apical aneurysm in a patient with normal coronary arteries residing in the United States.
真性左心室室壁瘤最常发生于急性透壁性心肌梗死之后。这些室壁瘤与心尖部假性室壁瘤不同，后者也可见于缺血性疾病，且具有不同的治疗过程。临床医生面临的主要难题是利用超声心动图信息进行鉴别。冠状动脉造影有助于进行这种鉴别；然而，在冠状动脉正常的情况下，必须考虑其他病因。对于无冠状动脉疾病或既往无心脏手术史的左心室室壁瘤患者，鉴别诊断范围很广，包括创伤性、感染性和浸润性病因。在本次电子挑战中，我们介绍了一位美国患者的左心室心尖部动脉瘤的不常见病因，该患者的冠状动脉正常。
