Left ventricular aneurysm classification

Left ventricular aneurysm Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

Left ventricular aneurysms are classified as true and false aneurysms. While both true aneurysms and false (pseudo) ventricular aneurysms are the sequelae of myocardial infarction, their etiology, pathologic findings, diagnostic findings, and treatment are different.

True Aneurysm

LV Aneurysm

Pseudo Aneurysm

True Left Ventricular Aneurysm

A true left ventricular aneurysm has an aneurysmal sac which contains the endocardium, epicardium, and thinned fibrous tissue (scar) that is a remnant of the left ventricular muscle. A true left ventricular aneurysm, particularly if small, may cause few or any symptoms and is compatible with prolonged survival. Rupture of a true aneurysm is relatively uncommon. Surgical resection is therefore only necessary when refractory angina pectoris, congestive heart failure, systemic embolization, or refractory arrhythmias are present.

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. A false aneurysmal sac represents a pericardium that contains a ruptured left ventricle. In contrast to true aneurysms, false aneurysms have a greater tendency to rupture and require surgical repair.

References

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