A Silent Dissection Complicating Myocardial Infarction: A Case Report
A Left Ventricular (LV) pseudoaneurysm develops when free myocardial wall rupture is contained by an adherent layer of overlying pericardium and scar tissue. It is a rare mechanical complication seen in 0.2% of patients post Myocardial Infarction (MI). Furthermore, it remains a challenge to diagnose...
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JCDR Research and Publications Private Limited
2025-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/20793/75635_CE[Ra1]_F(SL)_PF1(RI_SS)_PFA(IS)_PFA(IS)_PN(IS).pdf |
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| author | Adithya Shelley Akshat Sharma Jostol Pinto |
| author_facet | Adithya Shelley Akshat Sharma Jostol Pinto |
| author_sort | Adithya Shelley |
| collection | DOAJ |
| description | A Left Ventricular (LV) pseudoaneurysm develops when free myocardial wall rupture is contained by an adherent layer of overlying pericardium and scar tissue. It is a rare mechanical complication seen in 0.2% of patients post Myocardial Infarction (MI). Furthermore, it remains a challenge to diagnose and differentiate it from a true aneurysm due to overlapping clinical presentations and echocardiographic findings. A 40-year-old male patient presented with ST Elevation Myocardial Infarction (STEMI) and received guideline directed management. However, he was later found to have a pansystolic murmur at the apex and an early diastolic murmur over the left lower sternal border (to and fro murmur) on auscultation. An echocardiogram had subsequently revealed a dissecting pseudoaneurysm of the left ventricle and Contrast-enhanced Computed Tomography (CECT) confirmed the presence of an anterior dissecting pseudoaneurysm. This is an atypical presentation of a niche post MI complication due to its asymptomatic presentation, atypical location and unique anatomy despite prompt revascularisation. Furthermore, the authors emphasise the importance of cardiac auscultation on a day-to-day basis and high index of suspicion to ensure early diagnosis and management of such a silent, calamitous complication. |
| format | Article |
| id | doaj-art-ed36e0861dc74ed7809686edba1649e3 |
| institution | OA Journals |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-ed36e0861dc74ed7809686edba1649e32025-08-20T02:12:41ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193131510.7860/JCDR/2025/75635.20793A Silent Dissection Complicating Myocardial Infarction: A Case ReportAdithya Shelley0Akshat Sharma1Jostol Pinto2Department of Cardiology, Father Muller Medical College, Mangaluru, Karnataka, India.Department of Cardiology, Father Muller Medical College, Mangaluru, Karnataka, India.Associate Professor, Department of Cardiology, Father Muller Medical College, Mangaluru, Karnataka, India.A Left Ventricular (LV) pseudoaneurysm develops when free myocardial wall rupture is contained by an adherent layer of overlying pericardium and scar tissue. It is a rare mechanical complication seen in 0.2% of patients post Myocardial Infarction (MI). Furthermore, it remains a challenge to diagnose and differentiate it from a true aneurysm due to overlapping clinical presentations and echocardiographic findings. A 40-year-old male patient presented with ST Elevation Myocardial Infarction (STEMI) and received guideline directed management. However, he was later found to have a pansystolic murmur at the apex and an early diastolic murmur over the left lower sternal border (to and fro murmur) on auscultation. An echocardiogram had subsequently revealed a dissecting pseudoaneurysm of the left ventricle and Contrast-enhanced Computed Tomography (CECT) confirmed the presence of an anterior dissecting pseudoaneurysm. This is an atypical presentation of a niche post MI complication due to its asymptomatic presentation, atypical location and unique anatomy despite prompt revascularisation. Furthermore, the authors emphasise the importance of cardiac auscultation on a day-to-day basis and high index of suspicion to ensure early diagnosis and management of such a silent, calamitous complication.https://jcdr.net/articles/PDF/20793/75635_CE[Ra1]_F(SL)_PF1(RI_SS)_PFA(IS)_PFA(IS)_PN(IS).pdfechocardiogramleft ventricular pseudoaneurysmtrue aneurysm |
| spellingShingle | Adithya Shelley Akshat Sharma Jostol Pinto A Silent Dissection Complicating Myocardial Infarction: A Case Report Journal of Clinical and Diagnostic Research echocardiogram left ventricular pseudoaneurysm true aneurysm |
| title | A Silent Dissection Complicating Myocardial Infarction: A Case Report |
| title_full | A Silent Dissection Complicating Myocardial Infarction: A Case Report |
| title_fullStr | A Silent Dissection Complicating Myocardial Infarction: A Case Report |
| title_full_unstemmed | A Silent Dissection Complicating Myocardial Infarction: A Case Report |
| title_short | A Silent Dissection Complicating Myocardial Infarction: A Case Report |
| title_sort | silent dissection complicating myocardial infarction a case report |
| topic | echocardiogram left ventricular pseudoaneurysm true aneurysm |
| url | https://jcdr.net/articles/PDF/20793/75635_CE[Ra1]_F(SL)_PF1(RI_SS)_PFA(IS)_PFA(IS)_PN(IS).pdf |
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