Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2015; 7(7): 431-433
Published online Jul 26, 2015. doi: 10.4330/wjc.v7.i7.431
Giant and thrombosed left ventricular aneurysm
Jose Alberto de Agustin, Jose Juan Gomez de Diego, Pedro Marcos-Alberca, Jose Luis Rodrigo, Carlos Almeria, Patricia Mahia, Maria Luaces, Miguel Angel Garcia-Fernandez, Carlos Macaya, Leopoldo Perez de Isla
Jose Alberto de Agustin, Jose Juan Gomez de Diego, Pedro Marcos-Alberca, Jose Luis Rodrigo, Carlos Almeria, Patricia Mahia, Maria Luaces, Miguel Angel Garcia-Fernandez, Carlos Macaya, Leopoldo Perez de Isla, Instituto Cardiovascular, Hospital Universitario San Carlos, Profesor Martin Lagos s/n, 28040 Madrid, Spain
Author contributions: All the authors contributed to this manuscript.
Institutional review board statement: The case report was reviewed and approved by the Hospital Clinico San Carlos Institutional Review Board.
Informed consent statement: The patient provided informed written consent to publish the case report.
Conflict-of-interest statement: There is no conflict of interest concerning this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jose Alberto de Agustin, MD, PhD, Instituto Cardiovascular, Hospital Universitario San Carlos, Profesor Martin Lagos s/n, 28040 Madrid, Spain. albertutor@hotmail.com
Telephone: +34-91-3303394 Fax: +34-91-3303290
Received: March 7, 2015
Peer-review started: March 7, 2015
First decision: March 20, 2015
Revised: April 17, 2015
Accepted: April 28, 2015
Article in press: April 30, 2015
Published online: July 26, 2015
Processing time: 150 Days and 10.2 Hours
Abstract

Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

Keywords: Myocardial infarction; Echocardiography; Coronary artery disease; Left ventricular aneurysm; Coronary angiography

Core tip: Early diagnosis of ventricular aneurysms following acute transmural myocardial infarction is vital due to the serious complications that can occur. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic decompensated heart failure. Subsequent investigation revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. The peculiar findings of echocardiography, fluoroscopy and left ventriculography are shown with demonstrative images.