Left ventricular aneurysm pathophysiology
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Left ventricular aneurysm Microchapters |
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Differentiating Left ventricular aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Left ventricular aneurysm pathophysiology On the Web |
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American Roentgen Ray Society Images of Left ventricular aneurysm pathophysiology |
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Risk calculators and risk factors for Left ventricular aneurysm pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Aneurysm forms when intraventricular tension stretches the noncontracting infarcted heart muscle and thus produces expansion of the thin layer of necrotic muscle, and fibrous tissue that bulges with each cardiac contraction.
Pathophysiology
Gross Pathology
- The wall of a mature aneurysm is a white fibrous scar. Characteristically, the aneurysmal portion of the LV wall is thin and a mural thrombosis may be attached to the endocardial surfcace and may be calcified. The endocardium beneath retains its trabeculations, and the area of scarring is not clearly demarcated from the rest of the wall.
- The wall of the aneurysm becomes more densely fibrotic as the time passages, but it bulges outward with each cardiac contraction and causes some of the left ventricular stroke volume to be ineffective.
Microscopic findings
- On microscopic histopathological analysis hyalinized fibrous tissue is the predominant finding. However, a small number of viable muscle cells are usually present.[1]
- It takes 1 month for fibrous tissue to forms however, collagen tissue is formed during the first 10 days. So, when an aneurysm is said to be present within 1 week of a first myocardial infarction, the wall is composed largely of necrotic muscle and is not therefore by definition a true aneurysm.[2]
Images
The gross pathologic features of LV aneurysm are shown below.[3]
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Left ventricular aneurysm -
Left Ventricle Aneurysm: Gross natural color horizontal section apex of left ventricle with aneurysmal dilation and mural thrombus. A large scar tissue in myocardium. -
Left ventricular aneurysm. -
Heart; old myocardial infarction with aneurysm formation
References
- ↑ Gorlin R, Klein MD, Sullivan JM (1967). "Prospective correlative study of ventricular aneurysm. Mechanistic concept and clinical recognition". Am. J. Med. 42 (4): 512–31. PMID 6024720.
- ↑ PHARES WS, EDWARDS JE, BURCHELL HB (1953). "Cardiac aneurysms; clinicopathologic studies". Proc Staff Meet Mayo Clin. 28 (9): 264–71. PMID 13056012.
- ↑ Images courtesy of Professor Peter Anderson DVM PhD and published with permission. © PEIR, University of Alabama at Birmingham, Department of Pathology