Left ventricular pseudoaneurysm causing coronary angiography images resembling myocardial bridging

Int J Cardiovasc Imaging (2007) 23:135138 DOI 10.1007/s10554-006-9112-9

CASE REPORT

Left ventricular pseudoaneurysm causing coronary angiography images resembling myocardial bridging

Ibrahim Ozdogru Huseyin Arinc Ali Dogan Tugrul Inanc Nihat Kalay Emrullah Basar Tevk Tezcaner

Received: 25 April 2006 / Accepted: 25 May 2006 / Published online: 5 July 2006 Springer Science+Business Media B.V. 2006

Abstract Acquired pseudoaneurysm of the left ventricle is a rare disorder that usually ofvccurs after transmural myocardial infarction or after cardiac surgery. Pseudoaneurysms are usually detected because of symptoms; less often incidentally. Here we present a case of pseudoaneurysm as a result of unknown etiology causing myocardial bridging like image at angiography.

Keywords Pseudoaneursym Myocardial Bridging

Left ventricular pseudoaneurysm occurs as a consequence of rupture of the ventricular free wall and is conned by adherent pericardium or scar tissue. The rupture occurs in areas of mechanical weakness, most commonly after transmural myocardial infarction [13]. However, cases of ventricular pseudoaneurysm have been described after cardiac surgery, infective endo-

carditis, blunt force trauma, tumor inltration, penetrating injury and postmyocardial infarction despite normal coronary arteries [36]. Surgical resection is recommended because of the risk of spontaneous and fatal rupture of these pseudoaneurysms [7].

Case

A 46-year-old man had represented with retrosternal chest pain, which started 10 days before admission to the hospital. Three months ago he had been hospitalized with a similar complaint associated with ST segment and T wave changes on his electrocardiogram. Laboratory data had showed that cardiac enzymes were within normal limits, cardiac troponin T was negative, and left ventricle had normal cavity size and normal wall motions in echocardiographic examination. Based on these initial ndings the patient had been given medical treatment and discharged but advised to have coronary angiography as soon...