Post infarction pseudoaneurysm

Clinical and echocardiographic features in 22 cases

Tiong C. Yeo, Joseph F. Malouf, Guy S. Reeder, Jae Kuen Oh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background : Cardiac pseudoaneurysm (Ps) is an uncommon but frequently fatal complication of acute myocardial infarction. Objective : To review the clinical and echocardiographic features of patients with postinfarction Ps Design : Retrospective analysis of patients with postinfarction Ps seen at the Mayo Clinic between 1980 and 1996. Results : Twenty-two patients (17, 77% males, mean age= 68±10 years) with postinfarction Ps were identified. Ps was discovered incidentally in 5 (23%) patients who were asymptomalic. Four (18%) patients presented acutely, 3 as acute myocardial infarction and 1 in cardiac tamponade. Other clinical presentations included congestive heart failure in 3 (14%), chest pain in 3 (14%), syncope/arrhythmia in 4(18.2%) and systemic embolism in 3 (14%). The locations of the Ps were:inferior in 11, inferolateral in 7 and anterior in 4. Two-dimensional Doppler echocardiography was the diagnostic method used in 17 patients. Thrombus in the Ps cavity was seen in 5 patients. The ratio of maximal internal width of the communicating orifice to the maximal parallel diameter of the Ps cavity, O max/D max, was 0.45± 0.24, and was < 0.5 (previously defined as narrow neck) in 10 (63%) patients. Row in and out of the Ps cavity was detected on Doppler color flow imaging in all 17 patients who had an echocardiographic examination.Sixteen (73%) patients underwent surgical repair with an overall operative mortality of 12.5%. Six (27%) patients did not have surgery. After a median follow-up of 3.6 years, fourteen (64%) patients died (9 in surgical and 5 in medical group): 8 from non-cardiac causes, 3 from congestive heart failure and another 3 from recurrent myocardial infarction. There was no documented cardiac rupture. Total and cardiac mortality were not statistically different between the two treatment groups. Conclusions : 1). Two-dimensional Doppler echocardiography is useful in diagnosing this condition. Contrary to previous beliefs, a significant number of Ps have a wide neck. 2).Surgical repair has an acceptable operative mortality. 3).Cardiac rupture was uncommon in patients treated medically, and most deaths were related to underlying ischemic heart disease or associated medical conditions.

Original languageEnglish (US)
Pages (from-to)432
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - 1997

Fingerprint

False Aneurysm
Infarction
Heart Rupture
Doppler Echocardiography
Myocardial Infarction
Mortality
Neck
Heart Failure
Cardiac Tamponade
Syncope
Embolism
Chest Pain
Myocardial Ischemia
Cardiac Arrhythmias
Thrombosis
Color

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Post infarction pseudoaneurysm : Clinical and echocardiographic features in 22 cases. / Yeo, Tiong C.; Malouf, Joseph F.; Reeder, Guy S.; Oh, Jae Kuen.

In: Journal of the American Society of Echocardiography, Vol. 10, No. 4, 1997, p. 432.

Research output: Contribution to journalArticle

@article{5e1639322d224773a46495d2ff92c061,
title = "Post infarction pseudoaneurysm: Clinical and echocardiographic features in 22 cases",
abstract = "Background : Cardiac pseudoaneurysm (Ps) is an uncommon but frequently fatal complication of acute myocardial infarction. Objective : To review the clinical and echocardiographic features of patients with postinfarction Ps Design : Retrospective analysis of patients with postinfarction Ps seen at the Mayo Clinic between 1980 and 1996. Results : Twenty-two patients (17, 77{\%} males, mean age= 68±10 years) with postinfarction Ps were identified. Ps was discovered incidentally in 5 (23{\%}) patients who were asymptomalic. Four (18{\%}) patients presented acutely, 3 as acute myocardial infarction and 1 in cardiac tamponade. Other clinical presentations included congestive heart failure in 3 (14{\%}), chest pain in 3 (14{\%}), syncope/arrhythmia in 4(18.2{\%}) and systemic embolism in 3 (14{\%}). The locations of the Ps were:inferior in 11, inferolateral in 7 and anterior in 4. Two-dimensional Doppler echocardiography was the diagnostic method used in 17 patients. Thrombus in the Ps cavity was seen in 5 patients. The ratio of maximal internal width of the communicating orifice to the maximal parallel diameter of the Ps cavity, O max/D max, was 0.45± 0.24, and was < 0.5 (previously defined as narrow neck) in 10 (63{\%}) patients. Row in and out of the Ps cavity was detected on Doppler color flow imaging in all 17 patients who had an echocardiographic examination.Sixteen (73{\%}) patients underwent surgical repair with an overall operative mortality of 12.5{\%}. Six (27{\%}) patients did not have surgery. After a median follow-up of 3.6 years, fourteen (64{\%}) patients died (9 in surgical and 5 in medical group): 8 from non-cardiac causes, 3 from congestive heart failure and another 3 from recurrent myocardial infarction. There was no documented cardiac rupture. Total and cardiac mortality were not statistically different between the two treatment groups. Conclusions : 1). Two-dimensional Doppler echocardiography is useful in diagnosing this condition. Contrary to previous beliefs, a significant number of Ps have a wide neck. 2).Surgical repair has an acceptable operative mortality. 3).Cardiac rupture was uncommon in patients treated medically, and most deaths were related to underlying ischemic heart disease or associated medical conditions.",
author = "Yeo, {Tiong C.} and Malouf, {Joseph F.} and Reeder, {Guy S.} and Oh, {Jae Kuen}",
year = "1997",
language = "English (US)",
volume = "10",
pages = "432",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Post infarction pseudoaneurysm

T2 - Clinical and echocardiographic features in 22 cases

AU - Yeo, Tiong C.

AU - Malouf, Joseph F.

AU - Reeder, Guy S.

AU - Oh, Jae Kuen

PY - 1997

Y1 - 1997

N2 - Background : Cardiac pseudoaneurysm (Ps) is an uncommon but frequently fatal complication of acute myocardial infarction. Objective : To review the clinical and echocardiographic features of patients with postinfarction Ps Design : Retrospective analysis of patients with postinfarction Ps seen at the Mayo Clinic between 1980 and 1996. Results : Twenty-two patients (17, 77% males, mean age= 68±10 years) with postinfarction Ps were identified. Ps was discovered incidentally in 5 (23%) patients who were asymptomalic. Four (18%) patients presented acutely, 3 as acute myocardial infarction and 1 in cardiac tamponade. Other clinical presentations included congestive heart failure in 3 (14%), chest pain in 3 (14%), syncope/arrhythmia in 4(18.2%) and systemic embolism in 3 (14%). The locations of the Ps were:inferior in 11, inferolateral in 7 and anterior in 4. Two-dimensional Doppler echocardiography was the diagnostic method used in 17 patients. Thrombus in the Ps cavity was seen in 5 patients. The ratio of maximal internal width of the communicating orifice to the maximal parallel diameter of the Ps cavity, O max/D max, was 0.45± 0.24, and was < 0.5 (previously defined as narrow neck) in 10 (63%) patients. Row in and out of the Ps cavity was detected on Doppler color flow imaging in all 17 patients who had an echocardiographic examination.Sixteen (73%) patients underwent surgical repair with an overall operative mortality of 12.5%. Six (27%) patients did not have surgery. After a median follow-up of 3.6 years, fourteen (64%) patients died (9 in surgical and 5 in medical group): 8 from non-cardiac causes, 3 from congestive heart failure and another 3 from recurrent myocardial infarction. There was no documented cardiac rupture. Total and cardiac mortality were not statistically different between the two treatment groups. Conclusions : 1). Two-dimensional Doppler echocardiography is useful in diagnosing this condition. Contrary to previous beliefs, a significant number of Ps have a wide neck. 2).Surgical repair has an acceptable operative mortality. 3).Cardiac rupture was uncommon in patients treated medically, and most deaths were related to underlying ischemic heart disease or associated medical conditions.

AB - Background : Cardiac pseudoaneurysm (Ps) is an uncommon but frequently fatal complication of acute myocardial infarction. Objective : To review the clinical and echocardiographic features of patients with postinfarction Ps Design : Retrospective analysis of patients with postinfarction Ps seen at the Mayo Clinic between 1980 and 1996. Results : Twenty-two patients (17, 77% males, mean age= 68±10 years) with postinfarction Ps were identified. Ps was discovered incidentally in 5 (23%) patients who were asymptomalic. Four (18%) patients presented acutely, 3 as acute myocardial infarction and 1 in cardiac tamponade. Other clinical presentations included congestive heart failure in 3 (14%), chest pain in 3 (14%), syncope/arrhythmia in 4(18.2%) and systemic embolism in 3 (14%). The locations of the Ps were:inferior in 11, inferolateral in 7 and anterior in 4. Two-dimensional Doppler echocardiography was the diagnostic method used in 17 patients. Thrombus in the Ps cavity was seen in 5 patients. The ratio of maximal internal width of the communicating orifice to the maximal parallel diameter of the Ps cavity, O max/D max, was 0.45± 0.24, and was < 0.5 (previously defined as narrow neck) in 10 (63%) patients. Row in and out of the Ps cavity was detected on Doppler color flow imaging in all 17 patients who had an echocardiographic examination.Sixteen (73%) patients underwent surgical repair with an overall operative mortality of 12.5%. Six (27%) patients did not have surgery. After a median follow-up of 3.6 years, fourteen (64%) patients died (9 in surgical and 5 in medical group): 8 from non-cardiac causes, 3 from congestive heart failure and another 3 from recurrent myocardial infarction. There was no documented cardiac rupture. Total and cardiac mortality were not statistically different between the two treatment groups. Conclusions : 1). Two-dimensional Doppler echocardiography is useful in diagnosing this condition. Contrary to previous beliefs, a significant number of Ps have a wide neck. 2).Surgical repair has an acceptable operative mortality. 3).Cardiac rupture was uncommon in patients treated medically, and most deaths were related to underlying ischemic heart disease or associated medical conditions.

UR - http://www.scopus.com/inward/record.url?scp=0037742301&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037742301&partnerID=8YFLogxK

M3 - Article

VL - 10

SP - 432

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 4

ER -