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一例保守治疗的非典型左心室假性动脉瘤

An Atypical Left Ventricular Pseudoaneurysm Managed Conservatively.

作者信息

Chong Travis, Babu Aswin, Rajwani Adil, Best Matthew

机构信息

Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.

Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia; University of Western Australia, Perth, Western Australia, Australia.

出版信息

JACC Case Rep. 2025 Aug 20;30(24):104664. doi: 10.1016/j.jaccas.2025.104664.

Abstract

BACKGROUND

Left ventricle (LV) pseudoaneurysms pose a serious and life-threatening complication of myocardial infarction.

CASE SUMMARY

We present a case of a thrombosed LV pseudoaneurysm with clot extension into the LV cavity in an asymptomatic 62-year-old man presenting with nonsecific symptoms. Multimodal imaging was undertaken to confirm the diagnosis. Owing to the chronicity of the pseudoaneurysm, the patient was managed conservatively.

DISCUSSION

This case illustrates an alternative management approach in a clinical scenario with a paucity of data and no clear guidelines.

TAKE-HOME MESSAGES: Multimodal imaging is critical to distinguish LV pseudoaneurysms from true aneurysms, particularly in atypical locations, as accurate diagnosis directly affects management decisions. Although surgical repair remains the standard treatment for LV pseudoaneurysms, select chronic cases may be candidates for conservative management. Long-term follow-up data is needed to validate this approach.

摘要

背景

左心室假性动脉瘤是心肌梗死的一种严重且危及生命的并发症。

病例摘要

我们报告一例62岁无症状男性患者,其左心室假性动脉瘤形成血栓,血栓延伸至左心室腔,患者表现为非特异性症状。采用多模态成像以确诊。由于假性动脉瘤为慢性病变,对该患者采取了保守治疗。

讨论

本病例说明了在缺乏数据且无明确指南的临床情况下的一种替代管理方法。

要点

多模态成像对于区分左心室假性动脉瘤和真性动脉瘤至关重要,尤其是在非典型部位,因为准确诊断直接影响管理决策。虽然手术修复仍是左心室假性动脉瘤的标准治疗方法,但部分慢性病例可能适合保守治疗。需要长期随访数据来验证这种方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0278/12371349/f7285416e815/ga1.jpg

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