Geslin P, Pézard P, Lhoste P, Tadei A
Arch Mal Coeur Vaiss. 1980 Dec;73(12):1455-62.
A case of post-aneurysm detected by chance in an asymptomatic 41 year old man, 3 months after acute infarction, and managed by surgery is reported. Although the aneurysm was too small to cause chest X-Ray changes, the parietal defect was clearly defined by isotopic angioscintigraphy, CAT scanning and M-mode echocardiography. The features of pseudo-aneurysms on CAT scanning are discussed. The value of M-mode echocardiography is confirmed, it alone giving the precise diagnosis through the demonstration of one dynamic sign: systolic expansion of the aneurysmal pocket on a tracing more suggestive of a localised pericardial effusion than of ventricular aneurysm. Early diagnosis by these non-invasive methods of investigation, requested as a result of some initial clinical abnormality, confirmed by angiography, may benefit some patients as the risk of secondary rupture may be avoided by surgical cure. The rarity of this condition is also under question due to the increasing number of reported cases.
本文报告了一例41岁无症状男性在急性心肌梗死后3个月偶然发现的动脉瘤病例，并接受了手术治疗。尽管动脉瘤太小，未引起胸部X光改变，但通过同位素血管闪烁造影、计算机断层扫描（CAT扫描）和M型超声心动图明确界定了壁缺损。文中讨论了CAT扫描中假性动脉瘤的特征。证实了M型超声心动图的价值，它通过显示一个动态征象——动脉瘤腔在收缩期扩张，单独给出了精确诊断，该征象在描记图上更提示局限性心包积液而非室壁瘤。因某些初始临床异常而要求采用这些非侵入性检查方法进行早期诊断，并经血管造影证实，这可能使一些患者受益，因为通过手术治愈可避免二次破裂的风险。由于报告病例数不断增加，这种情况的罕见性也受到质疑。
