Clinical and imaging profile of left ventricular pseudo-aneurysm: a review of 77 cases

ABSTRACT

Objective To review the clinical characteristics of left ventricular pseudo-aneurysm (LVPA) in China mainland.Methods The China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information and PubMed database were searched to extract information on clinical profile,diagnostic imaging,treatment and outcome of patients with LVPA from January 1986 to April 2012.Results Clinical data of 77 patients with LVPAs (including 5 coexistent with true aneurysm) were extracted from 65 articles.There were 56 males (72.7％) and 11 females (27.3％) with a median age of 48 years old(range 5 to 82).The most common etiology was myocardial infarction (40,51.9％).Breathlessness/dyspnea (44.6％),chest discomfort (41.9％) and chest pain (41.9％) were the most frequently reported symptoms,but asymptomatic patients accounted for 10.8％ of all.86.4％ of the patients had electrocardiographic abnormalities,most of which were nonspecific ST segment changes.No event of thromboembolism was reported.Transthoracic echocardiography was the most commonly used diagnostic imaging test,followed by angiography with which no complication was reported.19 cases of pseudo-aneurysms(24.7％)were reported to rupture and 15 patients(19.5％) died,mostly of cardiac tamponade and sudden death.Conclusions LVPA is a rare and life-threatening disorder.It lacks of specific clinical manifestations distinguishable from coronary disease or heart failure.Emergency surgery is warranted once it is identified.