Willett Aimee, Glenn Zachary, Rose-Malkamäki Madison, Arshi Arash
OhioHealth Riverside Methodist Hospital, Internal Medicine Department, 3535 Olentangy River Road, Columbus, OH 43214, USA.
Ohio University Heritage College of Osteopathic Medicine, 6775 Bobcat Way, Dublin, OH 43016, USA.
Eur Heart J Case Rep. 2023 May 24;7(6):ytad248. doi: 10.1093/ehjcr/ytad248. eCollection 2023 Jun.
Recent advancements in cardiology have significantly decreased the incidence of post-myocardial infarction mechanical complications. When these sequelae occur, they can have high morbidity and mortality and may require aggressive intervention.
We describe a case of contained rupture of a large left ventricular aneurysm (LVA) presenting with syncope in a 60-year-old male with late presentation myocardial infarction (MI) 6 weeks prior on home triple antithrombotic therapy (TAT). Urgent pericardiocentesis along with imaging techniques including ultrasound, computed tomography angiography (CTA), and cardiac magnetic resonance imaging (MRI) were used for initial diagnosis. Definitive treatment was achieved with excision and repair of the LVA with return to prior functional status 1 month after intervention.
Highlights of this report emphasize the importance of differential diagnosis consideration of LVA with contained rupture in patient populations with prior late presentation MI and TAT. High clinical suspicion and thorough diagnostic workup with appropriate imaging are important to guide appropriate treatment interventions.
心脏病学的最新进展显著降低了心肌梗死后机械并发症的发生率。当这些后遗症发生时，它们可能具有高发病率和死亡率，可能需要积极干预。
我们描述了一例60岁男性患者，该患者在6周前因在家接受三联抗栓治疗（TAT）而出现延迟性心肌梗死（MI），现因大型左心室动脉瘤（LVA）局限性破裂伴晕厥就诊。紧急心包穿刺术以及包括超声、计算机断层血管造影（CTA）和心脏磁共振成像（MRI）在内的成像技术用于初步诊断。通过切除和修复LVA实现了确定性治疗，干预后1个月恢复到先前的功能状态。
本报告的重点强调了在先前有延迟性MI和TAT的患者群体中，鉴别诊断局限性破裂的LVA的重要性。高度的临床怀疑和使用适当成像进行全面的诊断检查对于指导适当的治疗干预很重要。
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