Heart 1998;80:98-100 ( July )
Case report
Left ventricular pseudoaneurysm in a patient with Dressler's
syndrome after myocardial infarction
a Department of
Cardiology and Angiology, Hospital of the Westfälische
Wilhelms-University, Münster, Germany, b Department of Thoracic and
Cardiovascular Surgery, Hospital of the Westfälische
Wilhelms-University
Correspondence to: Dr H Reinecke, Medizinische Klinik und Poliklinik
Innere Medizin C,
Westfälische Wilhelms-Universität, D-48129 Münster, Germany.
Accepted for publication 23 December 1997
Successful recanalisation of the left anterior descending
coronary artery was performed in a 51 year old man who was admitted two
weeks after acute anterior myocardial infarction. Fourteen days later,
the patient developed Dressler's syndrome with cardiac tamponade,
which was immediately punctured. Sternotomy was performed after two
weeks because of progressive haemodynamic deterioration, and fibrinous
masses were removed from the pericardium. The patient recovered but two
weeks later echocardiography showed a perforation of the left
ventricular free wall and formation of a pseudoaneurysm. Intensive
monitoring showed significant enlargement of the pseudoaneurysm, which
was subsequently resected. This case demonstrates that dangerous formation of a pseudoaneurysm can occur not only during the first days
of acute myocardial infarction but also after weeks in patients suffering from non-infectious pericarditis caused by Dressler's syndrome. Although the incidence of Dressler's syndrome is declining, patients should be monitored carefully for several weeks, especially by echocardiography.
© 1998 by Heart
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