A RARE POST-INFARCT LEFT VENTRICULAR SEPTAL PSEUDOANEURYSM WITH RUPTURE INTO THE RIGHT VENTRICLE: A DIAGNOSTIC CHALLENGE MIMICKING VENTRICULAR SEPTAL DEFECT
Recommended Citation
Fadel R, Memon M, Swanson B, Jamil D. A RARE POST-INFARCT LEFT VENTRICULAR SEPTAL PSEUDOANEURYSM WITH RUPTURE INTO THE RIGHT VENTRICLE: A DIAGNOSTIC CHALLENGE MIMICKING VENTRICULAR SEPTAL DEFECT. J Am Coll Cardiol 2025; 85(12):3150.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Am Coll Cardiol
Keywords
adult, assisted circulation, cardiogenic shock, case report, clinical article, complication, conference abstract, coronary artery bypass graft, coronary artery disease, diagnosis, extracorporeal oxygenation, false aneurysm, heart left atrium, heart left ventricle, heart right ventricle, heart ventricle septum defect, human, hypertension, male, non insulin dependent diabetes mellitus, revascularization, ST segment elevation myocardial infarction, surgery, thorax pain, veno-arterial ECMO
Abstract
Background: Left ventricular pseudoaneurysms are rare, potentially fatal complications of STEMI, posing diagnostic challenges when in atypical locations with perforation. Case A 62-year-old man with type 2 diabetes and hypertension presented four days post-chest pain, diagnosed with inferior STEMI. Coronary angiogram showed triple vessel disease, including 40% left main disease, not amendable to revascularization. He developed cardiogenic shock requiring left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO), with initial TTE suggesting VSD. Subsequent TEE identified a large pseudoaneurysm perforating into the right ventricle (figure 1). He underwent successful pseudoaneurysm exclusion and coronary bypass, discharging in stable condition. Decision-making This case underscores the importance of precise VSD and pseudoaneurysm detection via multimodality imaging, including TTE and TEE. The rare pseudoaneurysmʼs atypical location and perforation mimicked a VSD, highlighting mechanical circulatory supportʼs role in stabilizing post-STEMI complications before definitive surgery. Conclusion A contained left ventricular pseudoaneurysm perforating into the right ventricle post-STEMI is rare, with accurate diagnosis critical for guiding surgical intervention. [Formula presented]
Volume
85
Issue
12
First Page
3150
