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. 1989 Jan;61(1):59–64. doi: 10.1136/hrt.61.1.59

Advantages of colour flow imaging in the diagnosis of left ventricular pseudoaneurysm.

G R Sutherland 1, J H Smyllie 1, J R Roelandt 1
PMCID: PMC1216621  PMID: 2917100

Abstract

Eleven cases of left ventricular pseudoaneurysm in nine patients were studied by cross sectional echocardiography, conventional Doppler echocardiography, and colour flow imaging. In two patients recurrent pseudoaneurysms developed after cardiac surgery, three had acute rupture after myocardial infarction, two were the result of stab wounds, one was a late rupture of a true left ventricular aneurysm, one developed after surgical resection of a true left ventricular aneurysm, and two as a consequence of left ventricular venting. In all 11 cases the diagnosis was confirmed by angiographic or surgical information or both. The diagnosis was suspected clinically in only four cases. Cross sectional echocardiography alone confirmed the diagnosis in five cases. Neither pulsed wave Doppler nor continuous wave Doppler established the diagnosis when they were used without colour flow imaging in five and three cases respectively. In all 11 cases colour flow imaging showed flow in and out of the pericardial cavity at the defect site as well as the abnormal flow within the pseudoaneurysm. Subsequent use of pulsed Doppler showed a consistent "to and fro" flow pattern across the myocardial defect with characteristic respiratory variation of the peak systolic velocity. This unique intrapericardial flow pattern is diagnostic of a pseudoaneurysm. Colour flow imaging is a valuable addition to cross sectional and Doppler echocardiography, and is the best technique for detecting left ventricular pseudoaneurysms.

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61Fig 1
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62Fig 2
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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Botvinick E. H., Shames D., Hutchinson J. C., Roe B. B., Fitzpatrick M. Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm. Am J Cardiol. 1976 Jun;37(7):1089–1093. doi: 10.1016/0002-9149(76)90430-6. [DOI] [PubMed] [Google Scholar]
  2. Catherwood E., Mintz G. S., Kotler M. N., Parry W. R., Segal B. L. Two-dimensional echocardiographic recognition of left ventricular pseudoaneurysm. Circulation. 1980 Aug;62(2):294–303. doi: 10.1161/01.cir.62.2.294. [DOI] [PubMed] [Google Scholar]
  3. Coupe M., Dancy M., Pepper J. Coincidence of true and false left ventricular aneurysms after myocardial infarction. Br Heart J. 1986 Dec;56(6):567–568. doi: 10.1136/hrt.56.6.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Davidson K. H., Parisi A. F., Harrington J. J., Barsamian E. M., Fishbein M. C. Pseudoaneurysm of the left ventricle: an unusual echocardiographic presentation. Review of the literature. Ann Intern Med. 1977 Apr;86(4):430–433. doi: 10.7326/0003-4819-86-4-430. [DOI] [PubMed] [Google Scholar]
  5. Gatewood R. P., Jr, Nanda N. C. Differentiation of left ventricular pseudoaneurysm from true aneurysm with two dimensional echocardiography. Am J Cardiol. 1980 Nov;46(5):869–878. doi: 10.1016/0002-9149(80)90442-7. [DOI] [PubMed] [Google Scholar]
  6. Grube E., Redel D., Janson R. Non-invasive diagnosis of a false left ventricular aneurysm by echocardiography and pulsed Doppler echocardiography. Br Heart J. 1980 Feb;43(2):232–236. doi: 10.1136/hrt.43.2.232. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. HURST C. O., FINE G., KEYES J. W. PSEUDOANEURYSM OF THE HEART. REPORT OF A CASE AND REVIEW OF LITERATURE. Circulation. 1963 Sep;28:427–436. doi: 10.1161/01.cir.28.3.427. [DOI] [PubMed] [Google Scholar]
  8. Loperfido F., Pennestrì F., Mazzari M., Biasucci L. M., Vigna C., Laurenzi F., Manzoli U. Diagnosis of left ventricular pseudoaneurysm by pulsed Doppler echocardiography. Am Heart J. 1985 Dec;110(6):1291–1293. doi: 10.1016/0002-8703(85)90026-2. [DOI] [PubMed] [Google Scholar]
  9. Roberts W. C., Morrow A. G. Pseudoaneurysm of the left ventricle. An unusual sequel of myocardial infarction and rupture of the heart. Am J Med. 1967 Oct;43(4):639–644. doi: 10.1016/0002-9343(67)90187-8. [DOI] [PubMed] [Google Scholar]
  10. Saner H. E., Asinger R. W., Daniel J. A., Olson J. Two-dimensional echocardiographic identification of left ventricular pseudoaneurysm. Am Heart J. 1986 Nov;112(5):977–985. doi: 10.1016/0002-8703(86)90309-1. [DOI] [PubMed] [Google Scholar]
  11. Van Tassel R. A., Edwards J. E. Rupture of heart complicating myocardial infarction. Analysis of 40 cases including nine examples of left ventricular false aneurysm. Chest. 1972 Feb;61(2):104–116. doi: 10.1378/chest.61.2.104. [DOI] [PubMed] [Google Scholar]
  12. Vlodaver Z., Coe J. I., Edwards J. E. True and false left ventricular aneurysms. Propensity for the altter to rupture. Circulation. 1975 Mar;51(3):567–572. doi: 10.1161/01.cir.51.3.567. [DOI] [PubMed] [Google Scholar]

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