Left Ventricular Aneurysm

The Common Vein Copyright 2008

• Definition
  •  well delineated, thin, scarred, or fibrotic wall
  • devoid of muscle or containing necrotic muscle,
  • Causes of Left Ventricular Aneurysm and Pseudoaneurysm
    • • Post MI –
        • caused by total occlusion of the left anterior descending coronary artery and the absence of collateralization
        • RCA inferoposterior basal wall
        • Circumflex lateral wall
          • patients with multivessel disease,
            • aneurysms are uncommon  due to
            • extensive collateralization
      • hypertrophic cardiomyopathy and
      • Chagas disease,
  • Result
  • Functional
    • akinetic (without movement) or
    • dyskinetic
    • CHF
  • Structural
    • Size 1-8 cms
    • Shape
      • Round
    • Position
      •  apex and anterior wall are 70 to 85 %
      • inferoposterior basal wall RCA
      • lateral LVA secondary to left circumflex occlusion is exceedingly rare
    •  Character

• The wall of the aneurysm typically consists o
  • • white fibrous scar and is very thin.
    • organized clot in over 50 percent of cases
• Causes of Left Ventricular Aneurysm and Pseudoaneurysm
  • • Post MI –
    • hypertrophic cardiomyopathy and
    • Chagas disease,
  • Complications
    • CHF
    • ventricular arrhythmias
    • arrhythmias
    • Rupture – rare

Dr Lloyd Hawes

1 month later

 

 

01213

Courtesy Ashley Davidoff MD 01213 esophagus + fx dilated + fx fluid filled + dx achalasia of the cardia +cardiac heart LV apex left ventricle calcified calcification aneurysm thrombus RS pleura pleural calcification asbestos related disease imaging radiology CTscan

30472

This cross sectional CT image of the heart shows calcified apex of the left ventricle associated with thrombus, characteristic of an LV aneurysm. The cause is almost certainly secondary to coronary artery disease and ischemic heart disease with secondary myocardial infarction. Courtesy Ashley Davidoff MD. 30472 code heart LV apex IHD CAD aneurysm calcification calcified MI cardiac imaging radiology CTscan

30473

This cross sectional CT image of the heart shows calcified apex of the left ventricle associated with thrombus, characteristic of an LV aneurysm. The cause is almost certainly secondary to coronary artery disease and ischemic heart disease with secondary myocardial infarction. Courtesy Ashley Davidoff MD. 30473 code heart LV apex IHD CAD aneurysm calcification calcified MI cardiac imaging radiology CTscan

32074

This cross sectional CT image of the heart shows the apex of the left ventricle associated with thrombus, characteristic of an LV aneurysm. The cause is almost certainly secondary to coronary artery disease and ischemic heart disease with secondary myocardial infarction. Courtesy of Ashley Davidoff M.D. 32074 code heart LV apex aneurysm thrombus aneurysm IHD CAD MI large cardiac imaging radiology CTscan

 

33511

This transverse CT scan through the apex of the left ventricle shows a focal calcification at the apex. The diagnosis evolves into a focal pseudoaneurysm of the LV apex. Courtesy Ashley Davidoff MD 33511 code heart LV apex calcified pseudoaneurysm inflammation immune rheumatic heart disease RHD cardiac imaging radiology CTscan

 

33157

This power motion imaging echo of the heart showing a 4 chamber view, and demonstrating the left ventricle. The apex of the LV is rounded suggesting a LV aneurysm. Courtesy Philips Medical Systems 33157 code cardiac heart echo LV aneurysm dyskinetic segment apex imaging cardiac echo

 

42394.800

42394.800 heart cardiac LV left ventricle platypus shape fx dilated fx enlarged dyskinetic segment CTscan Davidoff MD

Pseudoaneurym at the base

References and Links

TCV

• Aneurysm
  • 046H LV Aneurysm and Pericardial Calcification
  • 055H LV Pseudoaneurysm with Hemopericardium
  • 060H LV Apical Aneurysm with Clot Over 1 year
  • 062H 78M PE RV iatrogenic pseudoaneurysm
  • 068H LV infero-basal aneurysm
  • Look Alikes
    • 023H Takotsubo and a Police Visit
    • 021H Takotsubo Broken Heart
    • LV Diverticulum
    • Pseudoaneurysm of the Left Ventricle