Fifty-three hearts with rupture of the ventricular septum complicating acute myocardial infarction (AMI) were studied. Thirty-three of the hearts were from men (average age 76 years) and 20 were from women (average age 73 years). The study showed 2 types of rupture of the ventricular septum: simple (28 patients) and complex (25 patients). Simple ruptures were direct through-and-through defects. Complex ruptures were associated with serpiginous dissection tracts remote from the primary site of tear of the ventricular septum. Specimens were classified as to the location of the underlying AMI and the level of the septum (apex to base) at which the rupture occurred. Twenty-nine hearts had an inferior AMI and 24 an anterior AMI. Complex ruptures occurred in 20 of the inferior AMIs (69%) and in 5 of the anterior AMIs (21%) (p

Ventricular septal rupture complicating acute myocardial infarction: identification of simple and complex types in 53 autopsied hearts.

https://vmj.sagepub.com/content/8/1/53.full.pdf

Clinical-pathologic conference.

Echocardiography showed a large anterior chamber communicating with the left ventricle cavity through the interventricular septum in a patient with a previous left ventricular aneurysmectomy. At postmortem examination this chamber proved to be an 11-cm diameter pseudoaneurysm that opened into the left ventricle through a 3-cm orifice. A review of the literature showed 67 cases of histologically proven left ventricular pseudoaneurysm, most of which occurred after myocardial infarction and cardiac surgery. Twenty-six of 32 left ventricular pseudoaneurysms were successfully operated upon. Among 35 patients with pseudoaneurysms not operated upon, rupture was a cause of death in 11.

Pseudoaneurysm of the Left Ventricle: an Unusual Echocardiographic Presentation: Review of the Literature

Pseudoaneurysm of the left ventricle after myocardial infarction: A curable form of myocardial rupture.

CARDIAC rupture is a major cause of mortality after myocardial infarction. 1,2 In a small percentage of patients, cardiac rupture is not a catastrophic event, but, rather, results in the formation of a pseudoaneurysm. Pseudoaneurysm is the result of ventricular rupture contained by adherent pericardium and fibrotic tissue. Pseudoaneurysm is thus characterized by the absence of myocardial tissue in its wall and a relatively narrow ostium between the ventricle and the paraventricular chamber (Fig 1). The plain-film finding of a paracardiac mass in a diaphragmatic or posterolateral location (Fig 2) in conjunction with a history of previous myocardial infarction is highly suggestive of pseudoaneurysm and is sufficient indication for angiographic studies. 3,4 Left ventriculography will show a paraventricular chamber filling via a relatively narrow ostium. The diagnosis is confirmed by demonstrating an avascular wall on coronary arteriography. 4 Report of a Case A 62-year-old man was admitted for syncope and

Left Ventricular Pseudoaneurysm: Its Recognition and Significance

In 2 cases myocardial infarction was complicated by the occurrence of a left ventricular false aneurysm. In the first case the aneurysm involved the anterolateral portion of the left ventricle; in the second the infarct was in the ventricular septum, and the resulting false aneurysm in the epicardium was basal in situation and extended posterior to each atrium. Whereas a true aneurysm of the left ventricle following myocardial infarction represents a bulging of a weakened left ventricular wall, a false aneurysm occurs as a result of rupture of the left ventricular wall. In contrast to a true aneurysm of the left ventricle, a false aneurysm has a wall consisting of fibrous tissue and is sharply demarcated from the cavity of the left ventricle. The rarity of false left ventricular aneurysms is related to the usual occurrence of fatal hemopericardium following rupture of the left ventricular wall.

False aneurysms of the left ventricle following myocardial infarction.

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False aneurysms of the left ventricle following myocardial infarction.