Unusual presentation of left ventricular rupture. Issue 1 (2nd February 2020)

• Record Type: Journal Article
• Authors: Bhullar, Amarbir S; Sandhu, Charnjeet Singh; Bhullar, Manminder S; Rathod, Ankit
• Is Part Of: BMJ case reports. Volume 13:Issue 1(2020)
• Publication Date: 2020-02-02
• Subjects: heart failure -- ischaemic heart disease -- clinical diagnostic tests -- radiology (diagnostics); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-231680
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We describe a case of 49-year-old man who presented with chest pain and was diagnosed with non-ST elevation myocardial infarction. Transthoracic echocardiogram (TTE) showed severe global hypokinesis of left ventricle with ejection fraction of 25%–30%. Left heart catheterisation showed severe right coronary stenosis and focal 60%–70% distal left anterior descending artery stenosis. Cardiac MRI (CMR) was done for evaluation of viability which showed a large pseudoaneurysm which was missed on TTE and left ventriculogram. Our case demonstrates the increasing importance of cardiac MRI in the diagnosis of left ventricular pseudoaneurysm. In our case left ventricular pseudoaneurysm was missed on TTE and left ventriculogram. It was diagnosed on CMR which was ordered for evaluation of myocardium viability.