Acute respiratory distress secondary to a huge chronic left ventricular pseudo-aneurysm

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Echo Research and Practice Pub Date : 2019-08-29 DOI:10.1530/ERP-19-0018

J. Hinton, George Hunter, M. Dissanayake, R. Hatrick

引用次数: 1

Abstract

Summary Pseudo-aneurysms are a rare, potentially life-threatening complication of a myocardial infarction. We present the case of a 45-year-old male who was brought to the emergency department in extremis and had a previous history of a late presentation inferior ST-elevation myocardial infarction treated percutaneously. Clinical examination revealed evidence of cardiogenic shock, pulmonary edema and a pulsatile epigastric mass. Chest X-ray demonstrated marked cardiomegaly and pulmonary edema. Urgent echocardiography confirmed the presence of a huge basal inferior wall pseudo-aneurysm with bi-directional flow. This was also associated with severe mitral regurgitation, due to posterior mitral annular involvement. The patient was transferred to the local cardiothoracic surgical unit where he underwent emergency repair of the pseudo-aneurysm and mitral valve replacement. Despite the surgery being complex he made a full recovery.

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巨大慢性左心室假性动脉瘤继发急性呼吸窘迫

假性动脉瘤是一种罕见的、可能危及生命的心肌梗死并发症。我们提出的情况下，一个45岁的男性谁被带到急诊科在极端和有一个晚期的历史表现下st段抬高心肌梗死经皮治疗。临床检查显示心源性休克，肺水肿和脉动性腹部肿块。胸部x线显示明显的心脏肿大和肺水肿。急诊超声心动图证实存在一个巨大的基底下壁假性动脉瘤伴双向血流。由于二尖瓣后环受累，这也与严重的二尖瓣反流有关。患者被转移到当地心胸外科，在那里他接受了假性动脉瘤的紧急修复和二尖瓣置换术。尽管手术很复杂，他还是完全康复了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echo Research and Practice CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.70

自引率

12.70%

发文量

审稿时长

8 weeks

期刊介绍： Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.