Left ventricular aneurysm: Difference between revisions

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__NOTOC__
'''For patient information, click [[Left ventricular aneurysm (patient information)|here]]'''
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = Left ventricular aneurysm|
   Image          = Heart left ventricular aneurysm sa.jpg|
   Image          = Heart lv aneurysm 4c.jpg|
  Caption        = Left ventricular aneurysm.|
  DiseasesDB    = |
  ICD10          = |
  ICD9          = |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = |
}}
}}
{{SI}}
{{Left ventricular aneurysm}}
{{CMG}}
{{CMG}}; {{AE}}{{MehdiP}}
 
'''Associate Editor in Chief:''' {{CZ}}
 
{{Editor help}}
 
==Overview==
'''Left ventricular aneurysm ''' (LVA) is a common sequela to myocardial infarction, occurring in 10% to 30% of patients surviving an acute myocardial
infarction.
 
==Classification of Left Ventricular Aneurysms==
Both true aneurysms and false ventricular aneurysms are the sequelae of [[myocardial infarction]]. However, their etiology, pathologic findings, diagnostic findings, and treatment are different.
 
===True Left Ventricular Aneurysm===
*True ventricular aneurysm is a chronic complication of myocardial infarction.
*A true aneurysmal sac contains the endocardium, epicardium, and thinned fibrous tissue (scar) that is a remnant of the left ventricular muscle, whereas a false aneurysmal sac represents a pericardium that contains a ruptured left ventricle.
*A true aneurysm, particularly if small, may cause no symptoms and is compatible with prolonged survival.
 
===False Left Ventricular Aneurysm or Pseudoaneurysm===
*Unlike a true aneurysm, which contains some myocardial elements in its wall, the walls of a false aneurysm are composed of organized hematoma and pericardium and lack any element of the original myocardial wall.
 
*'''An important difference is the lower potential for rupture of a true aneurysm compared with a false aneurysm.'''
**Rupture of a true aneurysm is an uncommon phenomenon; therefore, surgical resection is necessary only when refractory angina pectoris, [[congestive heart failure]], systemic embolization, or refractory arrhythmias are present.
**In contrast, false aneurysms may rupture and require surgical repair.


==[[Left ventricular aneurysm overview|Overview]]==
==[[Left ventricular aneurysm historical perspective|Historical Perspective]]==
==[[Left ventricular aneurysm classification|Classification]]==
==[[Left ventricular aneurysm pathophysiology|Pathophysiology]]==
==[[Left ventricular aneurysm causes|Causes]]==
==[[Left ventricular aneurysm differential diagnosis|Differentiating Left ventricular aneurysm from other Diseases]]==
==[[Left ventricular aneurysm epidemiology and demographics|Epidemiology and Demographics]]==
==[[Left ventricular aneurysm risk factors|Risk Factors]]==
==[[Left ventricular aneurysm screening|Screening]]==
==[[Left ventricular aneurysm natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Diagnosis==
==Diagnosis==


===ECG===
[[Left ventricular aneurysm history and symptoms|History and Symptoms]] | [[Left ventricular aneurysm physical examination|Physical Examination]] |
True aneurysms distort the shape of the left ventricle during both diastole and systole, and the motion of the aneurysmal segment is paradoxical. This can be associated with ST changes including ST elevation, particularly at high heart rates as might be encountered during exercise.
[[Left ventricular aneurysm laboratory findings|Laboratory Findings]] | [[Left ventricular aneurysm electrocardiogram|Electrocardiogram]] | [[Left ventricular aneurysm chest x ray|Chest X Ray]] | [[Left ventricular aneurysm CT|CT]] | [[Left ventricular aneurysm MRI|MRI]] | [[Left ventricular aneurysm echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Left ventricular aneurysm other imaging findings|Other Imaging Findings]] | [[Left ventricular aneurysm other diagnostic studies|Other Diagnostic Studies]]
 
==Radiographic Findings==
 
(Radiological Images Courtesy of RadsWiki)
 
===Chest X Ray===
The presence of a discrete bulge in the heart anteriorly is suggestive of a true aneurysm.


<gallery>
==Treatment==
Image:Calcified-ventricular-aneurysm-001.jpg|Calcified left ventricular aneurysm
Image:Calcified-ventricular-aneurysm-005.jpg|Calcified left ventricular aneurysm
</gallery>


===Chest CT Scan===
[[Left ventricular aneurysm medical therapy|Medical Therapy]] | [[Left ventricular aneurysm surgery|Surgery]] | [[Left ventricular aneurysm primary prevention|Primary Prevention]] | [[Left ventricular aneurysm secondary prevention|Secondary Prevention]] | [[Left ventricular aneurysm cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Left ventricular aneurysm future or investigational therapies|Future or Investigational Therapies]]
*True aneurysms will often have a wide neck and are often apical in location.
==Case Studies==
*False aneurysms will often have a narrow neck and are often posterior diaphragmatic in loccation.
 
<gallery>
Image:Calcified-ventricular-aneurysm-002.jpg|Calcified left ventricular aneurysm
Image:Calcified-ventricular-aneurysm-003.jpg|Calcified left ventricular aneurysm
Image:Calcified-ventricular-aneurysm-004.jpg|Calcified left ventricular aneurysm
</gallery>
 
==Pathology Findings==
<gallery>
Image:Heart left ventricular aneurysm sa.jpg|Left ventricular aneurysm
</gallery>
 
Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission. [http://www.peir.net © PEIR, University of Alabama at Birmingham, Department of Pathology]
 
<div align="left">
<gallery heights="175" widths="175">
Image:LV aneurysm1.jpg|Left Ventricle Aneurysm: Gross natural color horizontal section apex of left ventricle with aneurysmal dilation and mural thrombus. A large scar tissue in myocardium.
Image:LV aneurysm2.jpg|Left ventricular aneurysm.
Image:LV aneurysm3.jpg|Heart; old myocardial infarction with aneurysm formation
</gallery>
</div>


[[Left ventricular aneurysm case study one|Case #1]]
==References==
==References==
* Kumbasar, Basak, Wu, Katherine C., Kamel, Ihab R., Lima, Joao A. C., Bluemke, David A. [http://www.ajronline.org/cgi/content/short/179/2/472 Left Ventricular True Aneurysm: Diagnosis of Myocardial Viability Shown on MR Imaging.] Am. J. Roentgenol. 2002 179: 472-474.
{{reflist|2}}
* Eli Konen, Naeem Merchant, Carlos Gutierrez, Yves Provost, Linda Mickleborough, Narinder S. Paul, and Jagdish Butany. [http://radiology.rsnajnls.org/cgi/content/abstract/236/1/65 True versus False Left Ventricular Aneurysm: Differentiation with MR Imaging—Initial Experience.] Radiology 2005 236: 65-75.
 
==External Links==
*[http://goldminer.arrs.org/search.php?query=Left%20ventricular%20aneurysm Goldminer: Left ventricular aneurysm]
 
 
{{Circulatory system pathology}}
{{SIB}}


[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
 
[[Category:Ischemic heart diseases]]
[[Category:Intensive care medicine]]
[[Category:Emergency medicine]]


{{WH}}
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Latest revision as of 19:25, 9 November 2016

For patient information, click here

Left ventricular aneurysm

Left ventricular aneurysm Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Left ventricular aneurysm from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Left ventricular aneurysm from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

References

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