Left ventricular aneurysm natural history, complications and prognosis
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Left ventricular aneurysm Microchapters |
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Differentiating Left ventricular aneurysm from other Diseases |
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Treatment |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Natural History
If left untreated it may lead to rupture and hemodynamic compromise. Improvements in STEMI management, control of hypertension and avoidance of corticosteroids in STEMI have led to better prognosis and decreased mortality.[1]
Complications
- Mural thrombi: It occurs in almost 50% of patients and can be detected by angiography or echocardiography.
- Heart failure: Paradoxical movement in the aneurysmal portion of the LV wall reduces efficiency of the ventricle contraction and some part of stroke volume steals by aneurysm. It may lead to LV dilation and increase in LV end-diastolic pressure and may be accompanied by chest pain.[2][3]
- Arrhythmia: Approximately 15% have symptomatic ventricular arrhythmias that may be intractable and life-threatening.[4]
- Ventricular rupture: A mature true LV aneurysm rarely ruptures but it is common for false aneurysms.
References
- ↑ Mourdjinis A, Olsen E, Raphael MJ, Mounsey JP (1968). "Clinical diagnosis and prognosis of ventricular aneurysm". Br Heart J. 30 (4): 497–513. PMC 487659. PMID 5659397.
- ↑ Nicolosi AC, Spotnitz HM (1988). "Quantitative analysis of regional systolic function with left ventricular aneurysm". Circulation. 78 (4): 856–62. PMID 3168193.
- ↑ Klein MD, Herman MV, Gorlin R (1967). "A hemodynamic study of left ventricular aneurysm". Circulation. 35 (4): 614–30. PMID 6024006.
- ↑ Waldo AL, Arciniegas JG, Klein H (1981). "Surgical treatment of life-threatening ventricular arrhythmias: the role of intraoperative mapping and consideration of the presently available surgical techniques". Prog Cardiovasc Dis. 23 (4): 247–64. PMID 7008078.