Department of Cardiothoracic Surgery, Guangdong Provincial Hospital of Chinese Medicine, People's Republic of China.
Heart Surg Forum. 2021 Apr 29;24(2):E414-E417. doi: 10.1532/hsf.3679.
Left ventricular pseudoaneurysm (LVPA) is a rare complication of acute myocardial infarction (MI). As pseudoaneurysm is contained by the pericardium alone without involvement of myocardial tissue, LVPA are more prone to rupture and hence necessitates surgical intervention. We report a case of a 60-year-old man with acute MI due to a three-way occlusion in the coronary arteries. An emergency transthoracic echocardiogram (TTE) on the 11th day after the MI showed a small ventricular aneurysm, which was probably a late complication of the acute MI episode. A repeat TTE on the 26th day of the MI episode revealed a rapidly progressing LVPA. Emergency heart surgery was planned, but the patient died due to LVPA rupture. This case illustrates timely diagnosis and corrective surgery are key to saving patients from fatal LVPAs.
左心室假性动脉瘤（LVPA）是急性心肌梗死（MI）的罕见并发症。由于假性动脉瘤仅由心包包裹，而不涉及心肌组织，因此 LVPA 更容易破裂，因此需要手术干预。我们报告了一例 60 岁男性因冠状动脉三支闭塞导致急性 MI。MI 后第 11 天行急诊经胸超声心动图（TTE）显示有一个小的心室动脉瘤，可能是急性 MI 事件的晚期并发症。MI 发作第 26 天行重复 TTE 显示 LVPA 迅速进展。计划进行紧急心脏手术，但患者因 LVPA 破裂而死亡。本例说明了及时诊断和矫正手术是挽救患者免于致命性 LVPA 的关键。
