LEFT VENTRICULAR ANEURYSM
AbstractPost infarction true ventricular aneurysmmay be defined as a localized area of dyskinesiawith regional systolic expansion. The definitionfrom surgical observation leads to the followingcriteria: the presence of a scar like deformity ofthe ventricular wall, the presence of akinesia ordyskinesia, myocardial thinning or scar formationand the loss of trabecular pattern of theendocardium.It has become common clinical practiceto classify ventricular aneurysms with an externalbulge as true or false. The wall of the trueaneurysm is derived from the myocardium itselfwhereas the wall of the false aneurysm(pseudoaneurysm) is derived from the pericardium 2.The reported incidence of left ventricularaneurysm (LVA) ranges from 35% to 40%. Thiswide range is partly a reflection of a lack ofgenerally applied definitions 2’3. Aneurysmformation probably occurs within 3 months afterthe acute myocardial infarction (AMI) but hasbeen reported to be two weeks to two years afterAMI3. Factors such as a large transmural AMI andfirst AMI have been associated with LVA 4. Thegreatest risk of aneurysm follows infarction in thearea supplied by the left anterior descendingartery
Hamer DH & Lindsay J. Redefining true ventricular
aneurysm. Am J Cardiol, 1989, 64: 1192-94.
Davies MJ. Ischemic ventricular aneurysms: true or
false? Br Heart J, 1988, 60 :95-97.
Visser CA, Kan G, Meltzer RS et al. Incidence, timing
and prognostic value of left ventricular aneurysm
formation after myocardial infarction. A prospective
serial echocardiographic study of 158 patients. Am J
Cardiol, 1986, 57: 729-32.
Arvan S & Badillo P. Contractile properties of the left
ventricle with aneurysm. Am J Cardiol, 1985, 55: 338-
Morton KA, Alazraki NP, Taylor AT et al. SPECT
Thallium 201 Scintigraphy for the detection of left
ventricular aneurysm. J Nucl Med, 1987, 28: 168- 72.
Miller JM, Vassalo JA, Kussmaul WG et al. Anterior left
ventricular aneurysm. Factors associated with the
development of sustained ventricular tachycardia. J Am
Coll Cardiol, 1988, 12: 375-82.
Kromann HO, Block-Thomsen PE & Bagger H et al.
Surgery of ventricular tachycardia and ventricular
fibrillation in patients with coronary artery disease & LV
Lapeyre AC, Steele PM & Kazmier FJ et al. Systemic
embolism in chronic left ventricular aneurysm:
Incidence and the role of anticoagulation. J Am Coll
Cardiol, 1985, 6: 534-38.
Mangschau A. Akinetic versus dyskinetic left ventricular
aneurysms diagnosed by gated scintigraphy: Difference
in surgical outcome. Ann Thorac Surg, 1989, 47: 746-