Echocardiographic findings in false aneurysm of the left ventricle

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An aneurysm of the left ventricle after myocardial infarction may be either a true or false aneurysm. A false aneurysm of the left ventricle is a rare form of myocardial rupture, which restricts its expansion in the pericardial sac because of pericardial adhesions.1 Its early appearance resembles that of a localized hematoma. The intraventricular pressure seems to be one of the reasons that this hematoma expands into a saccular shape with communication with the left ventricular cavity by a small channel or neck.2 The mouth or neck of the false aneurysm is relatively small, compared with the diameter of the fundus of the aneurysm; and its wall consists of fibrous tissue (pericardial and fibrotic tissue from the resolving hematoma).2

The echocardiographic findings are described in two patients with false aneurysm involving the posterolateral wall of the left ventricle. The diagnosis in both cases was confirmed by surgery.

Case reports

Case 1. A 54-year-old white man had severe chest pain on January 12, 1975, while at work. He was admitted to a hospital where an electrocardiogram (ECG) showed findings compatible with an acute anterior wall myocardial infarction. Anticoagulant therapy was begun on the 2nd day of admission but was discontinued on the 3rd day because of the appearance of a pericardial rub. During that admission, he had recurrent anterior chest pain which was thought to be due to pericarditis. He was discharged after 25 days, and he felt well until the day of his second admission, when taking a deep breath, . . .



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